Kompendium 2020 Forschung & Klinik
Das Kompendium 2020 der Universitätsklinik für Orthopädie und Unfallchirurgie von MedUni Wien und AKH Wien (o. Univ.-Prof. R. Windhager) stellt einen umfassenden Überblick über die medizinsichen Leistungen und auch die umfangreichen Forschungsfelder dar. Die Veröffentlichungen zeigen die klinische Relevanz und innovative Ansätze der einzelnen Forschungsrichtungen. Herausgeber: Universitätsklinik für Orthopädie und Unfallchirurgie MedUni Wien und AKH Wien Prof. Dr. R. Windhager ISBN 978-3-200-07715-7
Das Kompendium 2020 der Universitätsklinik für Orthopädie und Unfallchirurgie von MedUni Wien und AKH Wien (o. Univ.-Prof. R. Windhager) stellt einen umfassenden Überblick über die medizinsichen Leistungen und auch die umfangreichen Forschungsfelder dar. Die Veröffentlichungen zeigen die klinische Relevanz und innovative Ansätze der einzelnen Forschungsrichtungen.
Herausgeber: Universitätsklinik für Orthopädie und Unfallchirurgie
MedUni Wien und AKH Wien
Prof. Dr. R. Windhager
ISBN 978-3-200-07715-7
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<strong>Kompendium</strong> <strong>2020</strong><br />
<strong>Forschung</strong> & <strong>Klinik</strong><br />
Universitätsklinik für<br />
Orthopädie und Unfallchirurgie<br />
MedUni Wien und AKH Wien<br />
ISBN 978-3-200-07715-7<br />
www.meduniwien.ac.at/ortho-unfall
.O.R.E.<br />
I N S T I T U T E
Inhalt/Impressum<br />
3<br />
Die <strong>Klinik</strong><br />
4 Editorial<br />
6 Klinische Leistungen und Operationen<br />
9 Hohe Ambulanzfrequenz durch Spezialangebote<br />
10 Interview mit o. Univ.-Prof. Dr. Reinhard Windhager:<br />
„Seltene Erkrankungen und komplizierteste Behandlungen<br />
sind unser Standard“<br />
14 Die Expertinnen und Experten auf einen Blick<br />
20 Ambulanzverzeichnis der Universitätsklinik<br />
für Orthopädie und Unfallchirurgie<br />
Impressum:<br />
Herausgeber:<br />
Universitätsklinik für<br />
Orthopädie und<br />
Unfallchirurgie MedUni Wien<br />
und AKH Wien<br />
o. Univ.-Prof. Dr. Reinhard<br />
Windhager<br />
Währinger Gürtel 18–20<br />
1090 Wien<br />
Redaktion & Gestaltung:<br />
Unlimited Media<br />
www.unlimitedmedia.at<br />
Lektorat: Sophie Hermann,<br />
BSc, Alexandra Lechner<br />
Fotos: iStock-120190423,<br />
Unlimited Media, MedUni<br />
Wien/Christian Houdek,<br />
Mark Glassner<br />
Druckerei: Copydruck KG<br />
Sandleitengasse 9–13<br />
1160 Wien<br />
Wien, Juli 2021<br />
ISBN 978-3-200-07715-7<br />
TOP-Studien<br />
22 Quantitative Biochemical MRI of Hyaline Cartilage<br />
26 Analysis of Running-Related Injuries: The Vienna Study<br />
30 Rheumatoid Arthritis Disease Activity and the Risk<br />
of Aseptic Arthroplasty Loosening<br />
34 OSTEOGROW: Acceleration of Bone Healing<br />
37 A Prediction Model for Total Knee Arthroplasty<br />
40 tPA Serum Antigen Levels Predict ARDS<br />
in Polytraumatized Patients<br />
43 3D Biochips for Research on Inflammatory<br />
Musculoskeletal Diseases<br />
46 Biological Regeneration in Early Osteoarthritis<br />
49 Total Hip Arthroplasties after Chiari Pelvic Osteotomy<br />
52 The MOCART 2.0 Knee Score: Morphological MRI<br />
for the Assessment of Cartilage Repair<br />
55 The Genetic Landscape of Axonal Neuropathies:<br />
Focus on MME<br />
58 Distal Femur Replacement – Differences between<br />
Oncologic and Non-Oncologic Conditions<br />
62 Biomechanical Evaluation of Intramedullary<br />
Jones Fracture Fixation<br />
65 Development of a New Electronic Navigation System<br />
Publikationen<br />
68 Originalarbeiten <strong>2020</strong><br />
E-Book<br />
www.meduniwien.ac.at/orthopaedie<br />
www.unlimitedmedia.at/orthopaedie<strong>2020</strong>
Editorial<br />
4<br />
Liebe Leserinnen und Leser!<br />
Es freut mich, Ihnen zum vierten Mal das <strong>Kompendium</strong> der gemeinsamen<br />
<strong>Klinik</strong> für Orthopädie und Unfallchirurgie, drei Jahre nach der Gründung dieser<br />
<strong>Klinik</strong> und nach einem bemerkenswerten Jahr, präsentieren zu können.<br />
o. Univ.-Prof. Dr. Reinhard Windhager<br />
Viel wurde in den letzten Monaten über die Auswirkungen der Pandemie<br />
reflektiert und publiziert, und es braucht nicht weiter ausgeführt zu werden,<br />
wie sehr sich diese weltweite Katastrophe auf unsere Leistungszahlen im<br />
klinischen Alltag niedergeschlagen hat. Trotz all dieser Belastungen ist es<br />
gelungen, spitzenmedizinische Leistungen weiter und in unveränderter<br />
Frequenz durchzuführen. Es sei allen Entscheidungsträgern gedankt, dass<br />
dies in einem tertiären Versorgungszentrum möglich gemacht wurde. Auch<br />
andere Aspekte dieser durch die Pandemie belasteten Zeit sollten nicht<br />
unerwähnt bleiben, wie die Intensivierung der Digitalisierung, die sich positiv<br />
im klinischen Alltag, aber vor allem im Bereich der wissenschaftlichen<br />
Kommunikation ausgewirkt hat.<br />
War es anfangs schwer vorstellbar, dass Workshops, Seminare, Symposien<br />
und auch größere Kongresse digital abgehalten werden, so ist dies mittlerweile<br />
zum Alltag geworden und wird in gewissem Ausmaß auch in Zukunft<br />
nicht mehr wegzudenken sein. Diese gewonnene Zeit hat sich auch in der<br />
regen Publikationstätigkeit niedergeschlagen und dazu beigetragen, dass<br />
zahlreiche neue Projekte initiiert werden konnten. Die folgenden Seiten<br />
sollen Ihnen einen kurzen Einblick in die Spitzenleistungen der <strong>Forschung</strong>saktivitäten<br />
unserer <strong>Klinik</strong>, die wie viele andere in Top-Journalen publiziert<br />
werden konnten, geben.<br />
An dieser Stelle sei auch allen Mitarbeiterinnen und Mitarbeitern für ihren<br />
unermüdlichen Einsatz in diesen schwierigen Zeiten gedankt und dafür, dass<br />
diese belastende Zeit positiv genutzt werden konnte.<br />
Ich wünsche Ihnen viel Vergnügen beim Studium dieser Lektüre und würde<br />
mich freuen, durch den einen oder anderen für Sie bemerkenswerten Aspekt,<br />
Interesse an einer zukünftigen Kooperation zu wecken.<br />
Ihr Reinhard Windhager
Zahlen und Fakten<br />
6<br />
Klinische Leistungen<br />
und Operationen<br />
Die Universitätsklinik für Orthopädie und Unfallchirurgie ist<br />
eine Großklinik mit einem umfassenden Leistungsspektrum.<br />
Trotz der umfangreichen Einschränkungen durch die Corona-Pandemie<br />
wurden im Jahr <strong>2020</strong> an der Universitätsklinik für Orthopädie und Unfallchirurgie<br />
insgesamt 6.530 Operationen durchgeführt. Im Jahr davor waren<br />
es 7.039 – allerdings ohne Corona-Einschränkungen.<br />
2.449 Operationen fielen in den Bereich der Orthopädie. Wobei hier betont<br />
werden muss, dass es sich zumeist um hochspezifische Eingriffe handelte, die<br />
an anderen Spitälern in Österreich gar nicht durchgeführt werden können. Es<br />
wurden 315 Hüftendoprothesen, 277 Knieendoprothesen und 149 Fusionen der<br />
Wirbelsäule durchgeführt. Hinzu kamen 341 Arthroskopien, 78 Fußoperationen,<br />
286 Tumorresektionen und 83 Osteosynthesen. An der Klinischen Abteilung für<br />
Unfallchirurgie wurden 3.265 Operationen durchgeführt.<br />
Klinische Leistung Orthopädie 2019 <strong>2020</strong><br />
Operationen gesamt 2.945 2.449<br />
unter anderem:<br />
Fusionen der Wirbelsäule 173 149<br />
Endoprothetische Versorgungen (gesamt) 731 653<br />
davon Hüftendoprothesen 349 315<br />
davon Knieendoprothesen 343 277<br />
Arthroskopien (alle Gelenke) 435 341<br />
Fußoperationen 132 78<br />
Tumorresektionen 372 286<br />
Osteosynthesen 94 83<br />
Klinische Leistung Unfallchirurgie<br />
Stationäre Aufnahmen 6.729 6.054<br />
Anzahl Operationen 4.094 3.265<br />
unter anderem:<br />
Endoprothetische Versorgungen (gesamt) 249 192<br />
Schädel-Hirn-Trauma 39 57<br />
Wirbelsäulen-OP 72 70<br />
Becken-/Acetabulum-Frakturen 13 32<br />
Knie-Binnenverletzungen 474 334<br />
Rekonstruktive Operationen an der Schulter 78 83<br />
Handverletzungen 409 329<br />
Thorax-/Abdomenverletzungen 34 24<br />
periprothetische Frakturen 43 46<br />
Osteosynthesen 763 606
Die bewährte<br />
Hüfte<br />
Qualität,<br />
die bewegt.<br />
www.implan-tec.at
Zahlen und Fakten<br />
9<br />
Hohe Ambulanzfrequenz<br />
durch Spezialangebote<br />
Die Universitätsklinik für Orthopädie und Unfallchirurgie versteht<br />
sich als universitäres Zentrum zur Diagnose, Therapie<br />
und Prävention von angeborenen und erworbenen Erkrankungen<br />
des Bewegungsapparates. Durch den hohen Grad an Spezialisierung<br />
und das große Angebot an Spezialambulanzen sind<br />
die Ambulanzen einer sehr starken Frequenz ausgesetzt. Die<br />
im Vergleich zu 2019 niedrigen Zahlen sind der Corona-Pandemie<br />
geschuldet – wobei bei den Versorgungen im Gipszimmer<br />
sogar eine massive Steigerung im Vergleich zu den Vorjahren<br />
bemerkbar war.<br />
In der Klinischen Abteilung für Orthopädie werden 21 höchst spezialisierte<br />
Ambulanzen auf internationalem Niveau angeboten. Insgesamt kam es im<br />
Jahr <strong>2020</strong> zu 23.306 Ambulanzbesuchen. Die höchsten Frequenzen wiesen<br />
folgende Ambulanzen auf: Schmerztherapie (2.343), Tumororthopädie<br />
(2.872), Rheumaorthopädie (2.486), Kinderorthopädie (1.805), Wirbelsäule<br />
(1.550), Sportorthopädie (1.512), Endoprothetik (1.133), Sarkome (852) und<br />
die Fußambulanz (403).<br />
2019 <strong>2020</strong><br />
Ambulante Frequenzen Orthopädie (gesamt) 31.800 23.306<br />
Schmerztherapie 5.097 2.343<br />
Tumororthopädie 3.738 2.872<br />
Rheumaorthopädie 3.019 2.468<br />
Kinderorthopädie 2.145 1.805<br />
Wirbelsäule 1.718 1.550<br />
Sportorthopädie 1.712 1.512<br />
Endoprothetik 1.320 1.133<br />
Knochen- und Weichteilsarkome 951 852<br />
Fußambulanz 694 403<br />
Ambulante Frequenzen Unfallchirurgie<br />
Ambulante Frequenzen (ABF) Erstversorgung 71.216 49.342<br />
Ambulante Kontrollen (ABK) Nachbehandlung 51.452 34.704<br />
SchockraumpatientInnen 566 507<br />
Eingriffe in der Wundversorgung 4.675 3.616<br />
Versorgungen im Gipszimmer 15.273 19.579
<strong>Klinik</strong><br />
10<br />
Seltene Erkrankungen und<br />
komplizierteste Behandlungen<br />
sind unser Standard<br />
Die Universitätsklinik für Orthopädie und Unfallchirurgie ist eine<br />
der größten im AKH Wien und der MedUni Wien und genießt<br />
vor allem im Bereich der hochspezialisierten Operationen<br />
internationalen Ruhm. Die Corona-Pandemie hat aber, bei der<br />
Behandlung der Patientinnen und Patienten, den über die letzten<br />
Jahre steigenden Operationsfallzahlen und auch im Bereich der<br />
<strong>Forschung</strong> massive Probleme bereitet und Rückgänge bewirkt.<br />
o. Univ.-Prof. Dr. Reinhard Windhager<br />
Welche Herausforderungen bewirkte die Corona-Krise im Jahr <strong>2020</strong> in<br />
Bezug auf die Behandlung der Patientinnen und Patienten?<br />
Das im Rahmen der Corona-Krise notwendige Schließen und konsekutive<br />
Öffnen von Spitalsressourcen ging mit einem enormen organisatorischen<br />
Aufwand einher, insofern als die Patientinnen und Patienten nicht auf einen<br />
bestimmten Termin verschoben werden konnten, sondern in permanenter<br />
Warteposition verharren mussten. Die sich ständig ändernde Verfügbarkeit<br />
von Ressourcen war mit einer massiven organisatorischen Belastung des<br />
gesamten ärztlichen und pflegerischen Personals verbunden.<br />
Welche Teile der Patientenversorgung kamen zu kurz? Was wurde an<br />
wichtigen Operationen verschoben, was wieder aufgeholt?<br />
Grundsätzlich kann festgehalten werden, dass medizinische Versäumnisse<br />
in keiner Weise zu verzeichnen waren, insofern als eine klare Priorisierung<br />
von medizinisch dringlich notwendigen Eingriffen erfolgte. So wurden auch<br />
während der Zeit des harten Lockdowns alle Tumoroperationen ebenso wie<br />
septische Eingriffe entsprechend der Notwendigkeit durchgeführt. Unter<br />
Berücksichtigung der Dringlichkeitsabstufung wurden Patientinnen und<br />
Patienten mit chronischen Erkrankungen ohne dringenden medizinischen<br />
Handlungsbedarf aufgeschoben und nach Ende des Lockdowns, spätestens<br />
mit 1. Juni <strong>2020</strong>, als alle Ressourcen wieder zu 100 Prozent zur Verfügung<br />
standen, bis zum Herbst operativ versorgt. Erfreulicherweise haben viele<br />
nicht dringliche Patientinnen und Patienten aufgrund der allgemeinen<br />
Verunsicherung und der Schwierigkeiten in der Nachbehandlung ihre<br />
Operationstermine bereits auf einen späteren Zeitpunkt verschoben.<br />
Welche Leistungen/Operationen bietet nur die Universitätsklinik für<br />
Orthopädie und Unfallchirurgie an, die sonst kaum oder gar nicht in<br />
Österreich gemacht werden können?
<strong>Klinik</strong><br />
11<br />
Neben der Polytrauma-Versorgung im unfallchirurgischen Bereich, die auf<br />
wenige Trauma-Zentren konzentriert ist, sind es vor allem komplexe Tumoroperationen<br />
und rekonstruktive Eingriffe im Bereich der Extremitäten und<br />
der Wirbelsäule. Hierunter fallen komplexe Gliedmaßenfehlbildungen wie<br />
Skolioseoperationen und En-bloc-Resektionen an der Wirbelsäule bei primär<br />
malignen Knochentumoren. Als tertiäres Versorgungszentrum sind wir auch<br />
die einzige Anlaufstelle für alle multimorbiden Patientinnen und Patienten,<br />
die sonst nirgendwo zur Operation aufgenommen werden.<br />
„Auch während der Zeit des harten<br />
Lockdowns in der Corona-Krise wurden<br />
alle Tumoroperationen ebenso<br />
wie septische Eingriffe entsprechend<br />
der Notwendigkeit durchgeführt.“<br />
Reinhard Windhager<br />
Hat sich die Krise auch auf die <strong>Forschung</strong>stätigkeit ausgewirkt?<br />
Die Zeit des Lockdowns hat sicherlich mehr Möglichkeiten geboten, Studien<br />
die bereits durchgeführt oder in Ausarbeitung waren, fertigzustellen und<br />
abzuschließen. Andererseits konnten interessante Konzepte für weitere Studien<br />
in dieser Zeit geboren werden. Dank dem Einsatz aller Mitarbeiterinnen<br />
und Mitarbeiter wurden prospektiv randomisierte Studien nur geringgradig<br />
in Bezug auf Rekrutierung während des Lockdowns beeinträchtigt, jedoch<br />
insgesamt nicht unterbrochen.<br />
Welche herausragenden <strong>Forschung</strong>sgebiete sehen Sie – in der Gegenwart,<br />
aber auch in der Zukunft?<br />
Entsprechend dem allgemeinen Trend der Personalisierung konzentrieren<br />
wir uns seit längerer Zeit nicht nur auf die Individualisierung von Behandlungskonzepten,<br />
sondern auch auf die differenzierte Planung und Durchführung<br />
von Operationen im Rahmen des institutionsübergreifenden Projektes<br />
des 3D-Druckverfahrens, das sowohl für Kunststoff als auch Metalle an der<br />
Universität umgesetzt werden kann. Weiter ausgebaut werden auch die Analyse<br />
von Biomarkern als Prognosefaktoren im Polytrauma-Management, die<br />
Anbindung verschiedenster differenzierter bildgebender Verfahren inklusive<br />
der biochemischen Bildgebung und das zukunftsträchtige <strong>Forschung</strong>sgebiet<br />
der Biochip-Technologie, mit der organtypische, gewebsähnliche Mikrosysteme<br />
als dreidimensionales Krankheitsmodell des Gelenkes dargestellt<br />
werden können und die degradative sowie inflammatorische Prozesse<br />
simulieren lässt.<br />
Wie liegt die MedUni bei der <strong>Forschung</strong> im internationalen Vergleich?<br />
Der wissenschaftliche Output der MedUni Wien kann der Homepage<br />
entnommen werden und ist mehr als beeindruckend. Auch in unserem<br />
Bereich ist eine kontinuierliche Zunahme des wissenschaftlichen Out -<br />
puts über die letzten Jahre und entsprechend der Zunahme der Impact-<br />
Faktoren auch ein kontinuierlicher Anstieg der Qualität der publizierten<br />
<strong>Forschung</strong>sergebnisse zu verzeichnen. Direkte Vergleiche mit anderen<br />
Institutionen sind nur schwer möglich, da die Ergebnisse öffentlich nur<br />
als Gesamtergebnis wiedergegeben werden und somit ein direktes<br />
Benchmarking verunmöglichen.<br />
Welche Kooperationen gibt es mit Firmen bzw. anderen <strong>Klinik</strong>en?<br />
Die Interaktion mit verschiedenen <strong>Klinik</strong>en ist durch die zahlreichen<br />
klinischen Boards bestens etabliert und im Alltag vollkommen integriert.<br />
Aus diesen klinischen Kooperationen, die alle wesentlichen Schwerpunkte<br />
der <strong>Klinik</strong> betreffen, ergeben sich zahlreiche Fragestellungen und damit<br />
Ansatzpunkte für neue <strong>Forschung</strong>sprojekte. Die Kooperationen mit den<br />
Firmen sind jahrelang etabliert, wobei für neue, interessante Aspekte<br />
weiterhin Platz sein wird.
<strong>Klinik</strong><br />
12<br />
Wie wirkt sich die <strong>Forschung</strong> auf die Patientinnen und Patienten aus?<br />
Entsprechend unserem Zugang als klinische Wissenschaftler ergeben sich<br />
die Fragestellungen aus dem klinischen Alltag, sodass die Ergebnisse in<br />
jedem Fall als klinisch relevant bezeichnet werden können und somit Auswirkungen<br />
auf klinische Entscheidungsprozesse oder Behandlungsmodalitäten<br />
von Patientinnen und Patienten haben.<br />
Wie haben sich die Änderungen in der Ausbildung an der <strong>Klinik</strong> etabliert?<br />
Durch die Umsetzung des neuen Ausbildungscurriculums ist eine intensivere<br />
Verbindung der beiden klinischen Abteilungen für Orthopädie und<br />
Unfallchirurgie eingetreten. Einzig und allein die hohe Vorhaltekapazität,<br />
welche durch die für den Akutbereich notwendige personelle Vorhaltekapazität<br />
der Unfallchirurgie bedingt ist, bewirkt ein Missverhältnis in der<br />
Rotation, sodass vereinzelt Teile der orthopädischen Ausbildungszeit an<br />
einer auswärtigen Institution verbracht werden müssen. Diesem Umstand<br />
kann allerdings durch die Notwendigkeit eines Auslandsaufenthaltes,<br />
der als Voraussetzung für eine klinische Karriere von der MedUni vorgeschrieben<br />
ist, Rechnung getragen werden.<br />
„Entsprechend dem allgemeinen Trend<br />
der Personalisierung konzentrieren<br />
wir uns seit längerer Zeit nicht nur auf<br />
die Individualisierung von Behandlungskonzepten,<br />
sondern auch auf die<br />
differenzierte Planung und Durchführung<br />
von Operationen im Rahmen des<br />
institutionsübergreifenden Projektes<br />
des 3D-Druckverfahrens, das sowohl<br />
für Kunststoff als auch Metalle an der<br />
Universität umgesetzt werden kann.“<br />
Reinhard Windhager<br />
Welche Ausbildungsinhalte sind für Sie wichtig?<br />
Die an unserer Universitätsklinik in Ausbildung Stehenden haben die einzigartige<br />
Möglichkeit, seltene Erkrankungen und komplizierteste Behandlungen<br />
in hoher Frequenz zu sehen, wodurch das Spektrum der Ausbildung wesentlich<br />
vergrößert wird.<br />
Wie wichtig ist die Zertifizierung zum Endoprothetikzentrum mit<br />
Maximalversorgung für die <strong>Klinik</strong>?<br />
Die frühere Universitätsklinik und jetzige klinische Abteilung für Orthopädie<br />
wurde als erstes Zentrum in Österreich zertifiziert und anerkannt.<br />
Die dadurch eingetretene Steigerung der Behandlungsqualität sollte<br />
eigentlich keiner Patientin, keinem Patienten vorenthalten werden, sodass<br />
zu fordern ist, dass eine flächendeckende Zertifizierung forciert wird.<br />
Patientinnen und Patienten haben das Recht, in transparenter Form über<br />
Behandlungserfolge informiert zu werden und darauf pochen zu können,<br />
dass das Minimum an Operationsfrequenz für die Durchführung des bevorstehenden<br />
Eingriffs zur Verfügung steht. Dies betrifft in weiterer Folge<br />
auch Revisionen, die ab einem gewissen Grad an ein Zentrum überwiesen<br />
werden sollten, um der Patientin, dem Patienten die maximale Behandlungsoption<br />
bieten zu können.<br />
Welche Fortschritte hat die Endoprothetik in den letzten Jahren gemacht?<br />
Neben einigen relevanten Neuerungen in der Implantologie, die sich auch<br />
klinisch ausgewirkt haben, sind es vor allem die verbesserte Planung und<br />
Planungsmöglichkeit der Endoprothetik mit entsprechender differenzierter<br />
Umsetzung, aber auch neue Methoden, wie die 3D-Drucktechnologie,<br />
die vor allem bei individuell angefertigten Prothesen im Beckenbereich Anwendung<br />
findet und durch neue Modifikationen eine deutlich verbesserte<br />
Osteointegration ermöglicht. Durch diese verschiedenen Differenzierungen<br />
sind jedoch mehr Fragen als Lösungen aufgetaucht, die die <strong>Forschung</strong><br />
enorm beflügelt haben.
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Das ÄrztInnenteam<br />
14<br />
Die Expertinnen und<br />
Experten auf einen Blick<br />
Neben dem Fortschritt in der Medizintechnik und innovativen<br />
Medikamenten sind vor allem die Mitarbeiterinnen und Mitarbeiter<br />
ein essenzieller Garant für den optimalen medizinischen<br />
Erfolg. Die rund 100 Ärztinnen und Ärzte der Universitätsklinik<br />
für Orthopädie und Unfallchirurgie im AKH Wien profitieren<br />
dabei auch vom exzellenten Netzwerk, dem wertschätzenden<br />
Umgang miteinander und der zielorientierten, individuellen<br />
Fort- und Weiterbildung.
Das ÄrztInnenteam<br />
15<br />
Universitätsklinik für Orthopädie und Unfallchirurgie<br />
Leiter: o. Univ.-Prof. Dr. Reinhard Windhager<br />
Klinische Abteilung für Orthopädie<br />
o. Univ.-Prof. Dr. Reinhard Windhager<br />
ao. Univ.-Prof. in Dr. in Catharina Chiari, MSc<br />
Univ.-Prof. Dr. Alexander Giurea<br />
Klinische Abteilung für Unfallchirurgie<br />
Assoz. Prof. Priv.-Doz. Dr. Stefan Hajdu, MBA<br />
Assoz. Prof. in Priv.-Doz. in Dr. in Silke Aldrian<br />
Mitarbeiterinnen und Mitarbeiter:<br />
(in alphabetischer Reihenfolge)<br />
Dr. Lukas Albrecht<br />
Dr. Jürgen Alphonsus<br />
Dr. in Anna Antoni<br />
Dr. Sebastian Apprich<br />
Univ.- Prof. in Dr. in Michaela Auer-Grumbach<br />
Mag. a Dr. in Rita Babeluk<br />
Dr. Sebastian Bachl<br />
Dr. Oskar Bamer<br />
Dr. in Elena Batrina<br />
DI Dr. Emir Benca<br />
Mag. a Marilena Bertacco<br />
Dr. Harald Binder<br />
Priv.-Doz. DDr. Christoph Böhler<br />
Dr. Robert Breuer (karenziert)<br />
Dr. Alexander Bumberger<br />
Dr. in Miroslava Cernakova<br />
Dr. in Britta Chocholka (karenziert)<br />
Dr. in Theresia Dangl<br />
Dr. Michél Dedeyan (karenziert)<br />
Dr. Stephan Döring<br />
Dr. in Nevenka Drmic<br />
Dr. Alexander Egkher<br />
Dr. Lukas Eichelberger<br />
Dr. Jozsef-Tibor Erdös<br />
Dr. in Emilia Eredansky<br />
Mag. a Seyma Ergün<br />
Dr. Georg Fraberger<br />
Dr. Stephan Frenzel<br />
Ass.-Prof. Dr. Martin Frossard (Internist)<br />
Assoz. Prof. Priv.-Doz. Dr. Philipp Funovics, MSc<br />
Dr. Markus Gregori<br />
Ass.-Prof. Dr. Manfred Greitbauer<br />
Univ.-Prof. Dr. Josef Grohs<br />
Dr. in Luiza Grünberg<br />
Dr. Thomas Haider, PhD<br />
Dr. Gabriel Halát<br />
Dr. in Martina Hamböck<br />
Dr. in Martina Hauser-Shinhan<br />
ao. Univ.-Prof. Dr. Thomas Heinz<br />
Dr. Stephan Heisinger<br />
Priv.-Doz. Dr. Gerhard Hobusch, MSc<br />
Assoz. Prof. Priv.-Doz. Dr. Marcus Hofbauer<br />
Dr. Florian Hofmann<br />
Dr. in Katharina Hohenstein-Scheibenecker<br />
Dr. in Sabrina Holzer, BA (karenziert)<br />
Dr. in Laura Hruby, PhD<br />
Dr. Florian Hruska<br />
Dr. Zhaohui Hu<br />
Dr. Michael Humenberger<br />
Dr. in Manuela Jaindl<br />
Dr. in Nina Janjic<br />
Dr. Nikolaus Jantsch<br />
Dr. Fatmir Kabashi<br />
Dr. Georg Kaiser<br />
Priv.-Doz. Dr. Maximilian Kasparek, MSc<br />
Univ.-Prof. Dr. Richard Kdolsky<br />
Dr. in Anne Kleiner<br />
Priv.-Doz. Dr. Alexander Kolb<br />
Dr. Paul Kolbitsch<br />
Dr. Ulrich Koller, MSc<br />
Dr. in Irena Krusche-Mandl<br />
Assoz. Prof. Priv.-Doz. Dr. Bernd Kubista, MSc<br />
Dr. in Roberta Laggner<br />
Dr. Nikolaus Lang, MSc<br />
Priv.-Doz. Dr. Richard Lass, MSc<br />
Assoz. Prof. Priv.-Doz. Dr. Johannes Leitgeb<br />
Dr. in Monika Luxl<br />
Ass.-Prof. Dr. Wolfgang Machold<br />
Dr. Bernhard Maier<br />
Dr. in Ulrike Marquart<br />
Dr. Michael Matzner<br />
Dr. Timon Moftakhar<br />
Dr. in Claudia Müller<br />
Priv.-Doz. Dr. Lukas Negrin, PhD, MSc<br />
Dr. Georgios Neophytou<br />
Dr. Arastoo Nia<br />
Dr. in Sylvia Nürnberger<br />
Dr. in Karin Pagano-Braun<br />
Ass.-Prof. Dr. Gholam Pajenda<br />
Assoz. Prof. Priv.-Doz. Dr. Joannis Panotopoulos<br />
DDr. Stephan Payr<br />
Dr. Stefan Plesser<br />
Dr. in Sigrid Polzer<br />
Dr. Domenik Popp<br />
Priv.-Doz. Dr. Stephan Puchner<br />
Dr. in Colleen Rentenberger<br />
Dr. Gregor Rettl
Das ÄrztInnenteam<br />
16<br />
Weitere Teammitglieder<br />
DI Dr. in Anna Rienmüller<br />
Dr. Stephan Salzmann<br />
Ass.-Prof. Dr. Klaus-Dieter Schatz<br />
Dr. Philip Schefzig<br />
Dr. Philipp Scheider<br />
Dr. in Eleonora Schneider<br />
Dr. Markus Schreiner<br />
Dr. Rupert Schuster<br />
Dr. Gilbert Schwarz<br />
Ass.-Prof. in Dr. in Elisabeth Schwendenwein<br />
Dr. Florian Sevelda, MSc<br />
Dr. in Irene Sigmund<br />
Ass.-Prof. Dr. Gobert Skrbensky<br />
Dr. Bernhard Springer<br />
Dr. Kevin Staats<br />
Dr. in Julia Starlinger, PhD (karenziert)<br />
Dr. in Beate Stelzeneder<br />
Dr. in Sandra Stenicka (karenziert)<br />
Priv.-Doz. Dr. Christoph Stihsen<br />
Ass.-Prof. Dr. Walter Stoik<br />
Dr. in Geraldine Sturz<br />
Dr. in Gerhild Thalhammer<br />
Dr. Thomas Tiefenböck, MSc<br />
Assoz. Prof. Priv.-Doz. Mag. Dr. Stefan Toegel<br />
Dr. Klemens Vertesich<br />
Dr. Rainer Wagner<br />
Ap. Prof. Priv.-Doz. Dr. Wenzel Waldstein-Wartenberg<br />
Dr. in Valerie Weihs<br />
Priv.-Doz. Dr. Harald K.Widhalm<br />
Dr. in Madeleine Willegger<br />
ao. Univ.-Prof. Dr. Gerald E. Wozasek<br />
Dr. Lukas Zak<br />
Dr. in Cornelia Zeitler<br />
Mag. a Dominika Zurawaska<br />
GastärztInnen und Beobachter im Jahr <strong>2020</strong><br />
Dr. Jamal Abdel-Karim Al-Omari,<br />
Dr. Chang-Bae Kong
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Das ÄrztInnenteam<br />
18<br />
Wiener Gesundheitsverbund<br />
Teilunternehmung AKH Wien<br />
Universitätsklinik für<br />
Klinische Abteilung für Orthopädie<br />
PatientInnenversorgung<br />
<strong>Forschung</strong><br />
Spezialambulanzen<br />
Schulter und Ellbogen<br />
Sportchirurgie Knie<br />
Hand<br />
Fuß<br />
Orthopädische<br />
Schmerzambulanz<br />
Hüfte<br />
Knie<br />
Knorpelschäden<br />
Neuromuskuläre<br />
Fussamb.<br />
Patellofemoral<br />
Knochen- und<br />
Weichteilsarkome<br />
Klumpfuß<br />
Extremitätendeformität<br />
Spezialteams<br />
Sportorthopädie<br />
Rheumaorthopädie<br />
Rehabilitation<br />
und Prothetik<br />
Komplexe Revision und<br />
Extremitätenrekonstruktionen<br />
Endoprothetik<br />
Kinderorthopädie<br />
Tumororthopädie<br />
<strong>Forschung</strong>scluster<br />
Arthrose und<br />
Geweberegeneration<br />
Deformitäten und<br />
Frakturheilung<br />
Endoprothetik<br />
Hand<br />
Infektionen<br />
Kinder<br />
Neuropathien<br />
Poly- und Schädelhirntrauma<br />
Sport und Gelenkserhaltung<br />
Tumor<br />
Spezielle<br />
biomedizinischtechnische<br />
Verfahren<br />
3D OP<br />
Ganganalyse<br />
MRT und biochemische<br />
Bilddiagnostik<br />
PROMS/RDA<br />
Rapid Prototyping<br />
RSA<br />
Skoliose und WS-<br />
Deformitäten<br />
Wirbelsäule<br />
Wirbelsäule
Das ÄrztInnenteam<br />
19<br />
Medizinische Universität Wien<br />
Orthopädie und Unfallchirurgie<br />
Klinische Abteilung für Unfallchirurgie<br />
Lehre<br />
PatientInnenversorgung<br />
Orthopädie<br />
Studierendenausbildung<br />
im Diplom- und<br />
Doktoratsstudium<br />
Unfallchirurgie<br />
Diplom- und<br />
Doktoratsstudium<br />
Erstbehandlungsambulanz<br />
+<br />
Nachbehandlungsambulanz<br />
Spezialambulanzen<br />
Postgraduelle Aus-/<br />
Weiterbildung<br />
inkl. PhD<br />
Facharztausbildung<br />
Postgraduelle Aus-/<br />
Weiterbildung<br />
inkl. PhD<br />
Facharztausbildung<br />
Wirbelsäulenverletzungen<br />
Traumatische Knorpelschäden<br />
Posttraumat. Deformitäten<br />
und Gliedmaßenrekonstruktion<br />
Kindertraumatologie<br />
Sportambulanz<br />
Handambulanz<br />
Schulterambulanz<br />
Hüftambulanz
Ambulanzen<br />
20<br />
Ambulanzverzeichnis der<br />
Universitätsklinik für<br />
Orthopädie und Unfallchirurgie<br />
Alle Spezialambulanzen der Klinischen Abteilung für Ortho pädie<br />
befinden sich auf Ebene 7D im AKH Wien unter dem grünen<br />
Bettenhaus und werden als Bestellambulanz geführt (telefonische<br />
Terminvereinbarung unter +43/1/404 00-40800). Die Zuweisung<br />
der Patientinnen und Patienten erfolgt durch die niedergelassenen<br />
Fachärztinnen und -ärzte für Orthopädie. Die Spezialambulanzen<br />
der Klinischen Abteilung für Unfall chirurgie und die Nachbehandlung<br />
in der Unfallambulanz sind auf Ebene 6 angesiedelt<br />
(telefonische Terminvereinbarung unter +43/1/404 00-59380).
Ambulanzen<br />
21<br />
Spezialambulanzen Klinische Abteilung für Orthopädie<br />
Spezialambulanz für orthopädische Schmerztherapie<br />
Endoprothesenzentrum der Maximalversorgung<br />
• Spezialambulanz für Endoprothetik<br />
• Spezialambulanz für Knie<br />
• Spezialambulanz für Hüfte<br />
• Spezialambulanz für komplexe Revisionen und Extremitätenrekonstruktionen<br />
Tumororthopädie<br />
• Spezialambulanz für Tumororthopädie<br />
• Spezialambulanz für Knochen- und Weichteilsarkome<br />
• Spezialambulanz für Rehabilitation und Prothetik<br />
Wirbelsäulenorthopädie<br />
• Spezialambulanz für Wirbelsäule<br />
• Spezialambulanz für Skoliose und Wirbelsäulendeformitäten<br />
Kinderorthopädie<br />
• Spezialambulanz für Kinderorthopädie<br />
• Spezialambulanz für Knorpelschäden<br />
• Spezialambulanz für Klumpfuß<br />
• Spezialambulanz für Extremitätendeformitäten<br />
• Neuromuskuläre Fußambulanz<br />
Rheumaorthopädie<br />
• Spezialambulanz für Rheumaorthopädie<br />
• Spezialambulanz für Fuß<br />
• Spezialambulanz für Hand<br />
Sportorthopädie<br />
• Spezialambulanz für Sportorthopädie<br />
• Spezialambulanz für Sportchirurgie Knie<br />
• Spezialambulanz für Schulter und Ellbogen<br />
Spezialambulanzen Klinische Abteilung für Unfallchirurgie<br />
• Allgemeine Unfallambulanz – Erstversorgung<br />
• Allgemeine Unfallambulanz – Nachbehandlung<br />
• Ambulanz für Kindertraumatologie<br />
• Ambulanz für Handchirurgie<br />
• Ambulanz für Hüftverletzungen und posttraumatische Hüftbeschwerden<br />
• Schulterambulanz<br />
• Ambulanz für traumatische Knorpelschäden<br />
• Ambulanz für posttraumatische Deformitäten und Gliedmaßenrekonstruktion<br />
• Ambulanz für Sportverletzungen<br />
• Ambulanz für posttraumatische Wirbelsäulenbeschwerden
TOP-Studien<br />
22<br />
Quantitative Biochemical MRI<br />
of Hyaline Cartilage<br />
„Our study demonstrated that T2<br />
mapping enables the quantification<br />
of patellar cartilage defect progression<br />
in untreated defects over time,<br />
[indicating its potential as a]<br />
predictive marker of patellar<br />
cartilage degeneration.“<br />
Sebastian Apprich<br />
The department of Orthopedic and Trauma Surgery at the Medical<br />
University of Vienna has conducted a successful interdisciplinary<br />
collaboration with the onsite High Field MR Centre of Excellence<br />
of Prof. Trattnig for years. A major goal is the implementation and<br />
improvement of new imaging techniques to explore the natural<br />
course of cartilage defects and its potential repair techniques.<br />
As a result of this collaboration the article „Potential predictive value of<br />
axial T2 mapping at 3 Tesla MRI in patients with untreated patellar cartilage<br />
defects over a mean follow-up of four years“ was published in the Journal of<br />
Osteoarthritis and Cartilage in <strong>2020</strong>. Magnetic resonance imaging (MRI), with<br />
its high spatial resolution and its capability for superior soft tissue contrast,<br />
represents the gold standard for diagnosis of incipient osteoarthritis, the<br />
follow up of its natural course, and the treatment options.<br />
High resolution MRI and newly developed semi-quantitative scoring systems<br />
allow for the morphological assessment of the whole joint in patients<br />
with Osteoarthritis (OA) (e.g. MOAKS (MRI Osteoarthritis Knee Score) and<br />
in patients after surgical cartilage repair (Whole joint MRI assessment of<br />
surgical cartilage repair of the knee: cartilage repair osteoarthritis knee<br />
score (CROAKS)). Additionally, new imaging techniques (T2/T2* Mapping,<br />
dGEMRIC, Sodium Imaging, gagCEST Imaging, …) have evolved over the<br />
recent year, which enable a deeper sight into the compositional structure<br />
of hyaline cartilage itself.<br />
Study:<br />
Apprich SR, Schreiner MM,<br />
Szomolanyi P, Welsch GH, Koller<br />
UK, Weber M, Windhager R,<br />
Trattnig S. Potential predictive<br />
value of axial T2 mapping at<br />
3 Tesla MRI in patients with<br />
untreated patellar cartilage<br />
defects over a mean follow-up<br />
of four years. Osteoarthritis<br />
Cartilage. Osteoarthritis Cartilage.<br />
<strong>2020</strong> Feb;28(2):215–222<br />
Advantages of T2 Mapping<br />
T2 mapping has proven the capability to gain information about water<br />
content and structure of the collagen fiber network of hyaline cartilage<br />
by assessment of quantitative T2 relaxation times. For several reasons, T2<br />
mapping provides some major advantages over other techniques. On one<br />
hand it is relatively independent from the available field strength of the MRI<br />
scanners and can be performed using a 1.5 Tesla scanner and upwards, on<br />
the other hand it does not require the administrations of a contrast agent<br />
and is feasible within a reasonable scan time.<br />
Within the aforementioned publication, we demonstrated the potential of<br />
axial T2 mapping for quantification of untreated early-stage patellar cartilage<br />
lesions over time and assessed its capability as a potential predictive<br />
marker for future progression. Our study cohort consisted of thirty patients<br />
(mean age, 36.7 ± 11.1 years; 16 males), with early-stage patellar cartilage
TOP-Studien<br />
23<br />
defects (≤ International cartilage repair Society (ICRS) grade 2) at baseline<br />
and no surgical or invasive treatment during the follow up (4.0 ± 1.6 years).<br />
To ensure the technical consistency especially of the T2 mapping, hardware,<br />
including the MR scanner and the knee coil, as well as the MR sequence<br />
protocol, was identical for all subjects at both time points.<br />
Following the ICRS grading system, morphological cartilage changes over<br />
time were subdivided into a progression group, a non-progression group and<br />
regression group. Quantitative analysis of cartilage defects was performed<br />
by means of global and zonal T2 mapping (deep and superficial cartilage T2<br />
values) at both time points.<br />
Figure 1:<br />
A 34-year-old female patient with an ICRS<br />
grade 1 cartilage defect of the lateral facet on<br />
high-resolution axial PD TSE morphological<br />
image at baseline MRI. The corresponding axial<br />
T2 map verifies a significant increase in global<br />
cartilage T2 values. Furthermore, on the medial<br />
apex of the T2 map, a punctual increase of T2<br />
values can be seen at the superficial layer,<br />
whereas the morphological image seems to<br />
prove that the cartilage is intact (A). At follow<br />
up after 3 ½ years (B), the morphological image<br />
showed a progression of the cartilage defect,<br />
not only for the lateral facet, but also for the<br />
medial apex. The corresponding T2 map shows<br />
a significant increase.
TOP-Studien<br />
24<br />
Figure 2:<br />
A 42-year-old male patient with suspected<br />
cartilage lesion at the apex of the patella on<br />
high-resolution axial PD TSE morphological<br />
image at baseline. The corresponding T2 map<br />
shows a diffuse and slight increase of T2 values<br />
in the same area (A). After 4 years (B), morphological<br />
cartilage status seems to have improved,<br />
together with a decrease of T2 values. The<br />
bisected white frames symbolize typical ROI<br />
placement for zonal assessment of deep and<br />
superficial T2 values.<br />
Results & Conclusions<br />
As a result, we found significantly higher global T2 values at baseline in the<br />
progression group (N = 11; 57.4 ± 7.8 ms), compared to patients without<br />
progression of cartilage defect size (N = 17; 40.6 ± 6.9 ms). Furthermore, the<br />
non-progression group showed only a minor increase in global T2 relaxation<br />
times (43.1 ± 7.9 ms; P = 0.07) at follow up, whereas in the progression group<br />
global (68,7 ± 19 ms; P = 0.02) and superficial T2 values (65,8 ± 8.2–79.8 ±<br />
24.4 ms; P = 0.03) increased significantly. T2 values for healthy reference cartilage<br />
remained stable (Figure 1). Surprisingly, in two patients an improvement<br />
in ICRS grading was observed (regression group), with decreasing T2 values.<br />
The ROC analysis showed an area under the curve of 0.92 (95%CI 0.82–1.0).<br />
At a cut-off value of 47.15 ms, we found a sensitivity of 92% (false-positive<br />
rate of 18%) for future progression of cartilage defects.<br />
Dr. Sebastian Apprich<br />
Author:<br />
Since 2019 Sebastian Apprich<br />
has been a consultant for<br />
Orthopedic and Trauma Surgery<br />
and coordinates the research<br />
activities of the Magnetic<br />
resonance Imaging Cluster.<br />
His clinical interests focus on<br />
joint preserving therapy as well<br />
as hand and foot surgery. As a<br />
result of his expanded research<br />
activities, he has (co)authored<br />
36 pubmed-listed articles and<br />
holds an actual h-index of 17<br />
points (scopus.com).<br />
Taken together, our study demonstrated that T2 mapping enables quantification<br />
of patellar cartilage defect progression in untreated defects<br />
over time. Furthermore, elevated cartilage T2 values at baseline were<br />
associated with longitudinal morphologic degeneration. Within this small<br />
patient cohort with early-stage patellar cartilage defects, T2 mapping<br />
seemed to be a potential predictive marker of patellar cartilage degeneration.<br />
Therefore, this axial T2 mapping sequence, in combination with the<br />
unique characteristics of the patella cartilage (thick cartilage, superficial<br />
and parallel position to the body surface) might be well suited for future<br />
prospective studies to evaluate the natural course of cartilage defects and<br />
their treatment in vivo.<br />
In the Future<br />
Furthermore, our future research will focus to overcome current limitations<br />
of 2-dimensional (2D) multi-echo-spin echo T2 mapping techniques in the<br />
quantitative assessment of hyaline cartilage of the whole joint. Therefore,<br />
further development of 3-D imaging techniques with possibility for multiplanar<br />
reconstruction and, even more important, improvements of the timeconsuming<br />
evaluation process of T2 maps by implementing automated segmentation<br />
techniques in combination with Gray-Level Co-Occurrence Matrix<br />
(GLCM) features will hopefully make quantitative T2 mapping more feasible<br />
for clinical OA-research purposes.
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TOP-Studien<br />
26<br />
Analysis of Running-Related<br />
Injuries: The Vienna Study<br />
„Running-related injuries are multifactorial,<br />
associated with personal data,<br />
training load, anatomic malalignments,<br />
and injury history. While it is impossible<br />
to define a one-fits-all formula to reduce<br />
the risk for RRI in general, runners with<br />
a high risk of a specific injury could be<br />
identified based on patient-specific training<br />
profiles and running gaits, as well as<br />
on pre-existing malalignments […], with<br />
their diagnosis leading to an appropriate<br />
and balanced training adaptation.“<br />
Emir Benca<br />
Most injuries related to running training manifest themselves<br />
during the month of March. Knee injuries are particularly common,<br />
and women seem to injure themselves more often than men. This<br />
was the finding of a study conducted by the MedUni Vienna and<br />
the Orthopädiezentrum Innere Stadt using data from Viennese<br />
runners. The study has recently been published in the Journal of<br />
Clinical Medicine.<br />
According to current surveys, running is one of the favorite sport activities<br />
across the globe. Fourteen percent of Austria’s population, age 15 and older,<br />
are running at least once-, while another 17% are running less than once a<br />
week, but still regularly. Despite the well-known health benefits of regular<br />
running exercises, running is associated with running-related injuries (RRI)<br />
with a yearly incidence of up to 79%. Studies suggest 7.7 running-related<br />
injuries for recreational runners, and 17.8 for novice runners per 1,000 hours<br />
of running, and the vast majority of them are related to overuse. The aims of<br />
this study were the presentation of a heterogeneous running population with<br />
running-related injuries, the analysis of a broad range of potential contributing<br />
factors for most common RRIs and their combinations, and the investigation<br />
if different running footwear categories affect injury incidences.<br />
Study:<br />
Benca E, Listabarth S, Flock<br />
FKJ, Pablik E, Fischer C,<br />
Walzer SM, Dorotka R, Windhager<br />
R, Ziai P. Analysis of<br />
Running-Related Injuries:<br />
The Vienna Study. J Clin Med.<br />
<strong>2020</strong> Feb 6;9(2):438<br />
Methods & Data<br />
Using a thorough questionnaire in combination with malalignment and injury<br />
data, a detailed description of a large population with running-related injuries<br />
was presented. The running population is characterized by its heterogeneity, a<br />
long running history, and a detailed description of the training data. The presentation<br />
of the number of injured runners over the months shows a normal distribution<br />
with a peak in March (Figure 1). An increase was observed during the<br />
early winter months. This observation coincides with the onset of the „Vienna<br />
City Marathon“, the largest national running event with over 40,000 participants,<br />
which is held on the second weekend in April each year. While there<br />
is no evidence that participating in long-distance races is associated with<br />
overuse injuries, the presented data suggest that the accompanying increase<br />
in training load must occur incrementally and include regeneration periods.<br />
The observed injuries came exclusively from overuse. 178 patients suffered<br />
from 244 injuries with 44 specific diagnoses, 45 were secondary injuries<br />
to the one and same location. The injuries were mainly located at the knee<br />
(41.2%), followed by the ankle joint (15.0%), and the foot (10.6%). Most<br />
common were the patellofemoral pain syndrome (PFPS) (13.4%), the iliotibial
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27<br />
5<br />
5<br />
Patients (-)<br />
10 15 20 25 30<br />
Injury frequenca (-)<br />
10 15 20<br />
Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep<br />
PFPS<br />
ITBFS Patellar tendinopathy Spinal injuries Ankle instability<br />
Figure 1: Month of presentation.<br />
Figure 2: Distribution of most common RRIs across sexes and age groups.<br />
band friction syndrome (ITBFS) (12.3%), patellar tendinopathy (12.3%), spinal<br />
injuries (11.2%), and instability of the ankle joint (8.4%) (Figure 2).<br />
Results<br />
The authors evaluated the association between the following factors: sex, age,<br />
height, BMI, activity history, weekly activity hours, weekly mileage, weekly frequency,<br />
as well as individual training habits (e.g. warming up, stretching) and<br />
various anatomic malalignments with the five most common injury locations<br />
including most common specific injuries in these sites. Knee injuries were positively<br />
associated with lower BMI, and previous injury with similar complaints<br />
as well as with malalignments (knee malalignment, especially varus knee,<br />
and pes planus). The patellofemoral pain syndrome was positively associated<br />
with lower training frequency, knee malalignment, and with lower height. The<br />
iliotibial band friction syndrome showed a positive association with previous<br />
injury and a negative association with BMI. Patients with patellar tendinopathy<br />
had a lower BMI, showed a lower running pace, but more often knee and less<br />
often hip malalignments than the others. Patients with injuries at the foot/<br />
ankle reported less often a history of similar previous injuries and showed<br />
a negative association with knee malalignment and pes planus, while ankle<br />
instability was positively associated with weekly activity and pes cavus. Hip/<br />
pelvis patients showed a positive association with running experience, scoliosis,<br />
and patellar squinting, and a negative one with stretching after the run.<br />
Lower back (spinal) injury patients showed a high proportion of scoliosis and<br />
were positively related to higher BMI, but negatively to the varus knee. Injuries<br />
to the lower leg were observed in patients with a higher running pace but had<br />
a negative relationship with malalignment of the knee.<br />
It is important to mention that single variables associated with a specific injury<br />
or injury location must not be regarded as isolated contributing factors.<br />
A RRI is the result of multiple associated factors in terms of anthropometrics<br />
and malalignments in combination with previous injury history and exposure<br />
to certain training load. None of the sustained RRI’s is associated with a<br />
single variable only. An injury is sustained when the interaction of predisposing<br />
factors, positive injury history, and a reached threshold in training load<br />
becomes significant. Research questions should not focus on the effect of<br />
single variables on a specific injury, but on specific injuries as a combination<br />
of multiple variables as well as on the weighting of those variables in injury
TOP-Studien<br />
28<br />
prediction models. For example, our data showed BMI to be associated with<br />
multiple injuries or injury sites, however, never as predominant regression<br />
weight, when compared with other significant variables. On the other hand,<br />
the odds to suffer PFPS, patellar tendinopathy or a knee injury in general, are<br />
much higher in patients with knee malalignments. In other words, a present<br />
knee malalignment will contribute more to the risk to suffer from a RRI than<br />
BMI does, and therefore shows different clinical relevance. The patients<br />
were not able to provide sufficient data to properly address the question if<br />
different running footwear categories modify injury incidences. Interestingly,<br />
a relatively low proportion of runners with the pes valgus deformity wear<br />
motion-controlled traditional running shoes, even though they are recommended<br />
specifically for them.<br />
DI Dr. Emir Benca<br />
Author:<br />
Emir Benca holds a masters’<br />
degree from TU Wien and a<br />
PhD from Medical University of<br />
Vienna. He is the head of the<br />
Adolf Lorenz Lab for Biomechanics<br />
and coordinates the<br />
rapid prototyping cluster at<br />
the Department of Orthopedics<br />
and Trauma Surgery. He<br />
is currently working at the AO<br />
Research Institute Davos as a<br />
visiting scientist. Dr. Benca has<br />
participated in several half- and<br />
full marathons, as well as the<br />
Ironman 70.3 Austria in 2018.<br />
Sex Discrepancy<br />
A possible sex discrepancy (56% female, 44% male, ratio female: male: 1.25)<br />
was observed in this study, indicating either a generally higher number of<br />
female runners, women consulting a medical doctor sooner, or a higher injury<br />
rate in women than men. While earlier studies showed lower ratios (0.76),<br />
more recent literature shows a higher incidence in female injured runners<br />
(1.16), suggesting that running nowadays is not predominantly a male sport.<br />
Data from a nationwide survey have reported a ratio over the past five years<br />
between female and male Austrians, who run at least once a week, to be<br />
0.78 (range: 0.65 – 0.89). The „Vienna City Marathon” showed a finisher ratio<br />
of 0.52 (range 0.48 – 0.55) for the half- and 0.24 (range 0.22 – 0.28) for the<br />
full marathon (both increasing) over the same period. If the injury incidence<br />
across sexes was equal, the anticipated result would be a higher incidence of<br />
RRIs in men, especially across runners with higher total activity. Those runners<br />
are more likely to participate in long-distance races. However, the sex ratio in<br />
runners in the present study with five or more years of experience was 1.04. To<br />
investigate if there was a difference in visit rates to doctors among sexes, the<br />
patients were asked to indicate how often they visited a doctor per year. Women<br />
reported 2.6 visits, which is 0.35 times more than men, which corresponds to<br />
the well documented average yearly gynecologist visit rate of 0.41, which could<br />
explain the higher rate in medical visits in women. In summary, the female to<br />
male discrepancy seems to be based on a higher injury rate in women rather<br />
than a higher number of female runners in general, a higher participation rates<br />
in race events, or more frequent medical consultations in women.<br />
Conclusion<br />
In conclusion, running-related injuries are multifactorial, associated with<br />
personal data, training load, anatomic malalignments, and injury history. While<br />
it is impossible to define a one-fits-all formula to reduce the risk for RRI in<br />
general, runners with a high risk of a specific injury could be identified based on<br />
patient-specific training profiles and running gaits, as well as on pre-existing<br />
malalignments, such as scoliosis, patellar squinting, knee malalignments,<br />
and/or varus knee, with their diagnosis leading to an appropriate and balanced<br />
training adaptation. Furthermore, awareness of injury risks and prevention<br />
should be raised in running schools and by medical specialists.<br />
In the end, running has remained a popular activity over decades, even though<br />
it has been associated with a high incidence of overuse injuries. By presenting<br />
the injuries the authors did not aim to discourage from running, but to provide<br />
data for better understanding and to contribute to their prevention. We believe<br />
running is still beneficial in many respects, enriching, and simply fun.
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TOP-Studien<br />
30<br />
Rheumatoid Arthritis Disease<br />
Activity and the Risk of Aseptic<br />
Arthroplasty Loosening<br />
Rheumatoid arthritis (RA) is characterised by typical joint inflammation<br />
and synovitis, which, if not treated effectively, leads to joint<br />
destruction and functional disability. Although new treatment<br />
strategies improved long-term outcomes tremendously, rates of<br />
total hip and knee arthroplasty (THA/TKA) in patients with RA<br />
remain considerable.<br />
As RA differs fundamentally from osteoarthrosis (OA) in terms of prognosis,<br />
pathogenesis, and medical treatment, outcomes of total joint arthroplasty<br />
(TJA) and rates of complications would be expected to be different between<br />
these two diseases. Aseptic loosening is the most common cause for surgical<br />
revision after TJA with far-reaching implications, including an exchange of the<br />
implant associated with decreased function, loss of bone stock and an increased<br />
risk for further complications. Reasons for aseptic loosening are not<br />
fully understood, but local inflammation is suspected to play a crucial role.<br />
Systemic inflammation in RA might influence this process of local inflammatory-mediated<br />
osteolysis and could lead to higher aseptic loosening rates<br />
in RA patients, especially in those with increased inflammatory activity. The<br />
objective of this study was to assess the influence of RA disease activity on<br />
the risk of aseptic loosening after TJA. Furthermore, we evaluated if antirheumatic<br />
therapy has an influence on the risk of aseptic loosening. Additionally,<br />
we analysed the rates of radiographic aseptic loosening in OA patients, as a<br />
control group without systemic inflammation.<br />
Study:<br />
Böhler C, Weimann P, Alasti F,<br />
Smolen JS, Windhager R, Aletaha<br />
D. Rheumatoid arthritis<br />
disease activity and the risk of<br />
aseptic arthroplasty loosening.<br />
Semin Arthritis Rheum. <strong>2020</strong><br />
Apr; 50(2):245–251<br />
Patients and Methods<br />
We ascertained data of 49 RA patients who underwent primary TJA with a<br />
fully documented disease activity as well as a complete clinical and radiological<br />
follow-up for analysis. Further we investigated a cohort of OA patient,<br />
who were matched 2:1 for sex, age, date of surgery, and location of TJA as a<br />
control group without systemic inflammation. We obtained demographic data,<br />
comorbidities, antirheumatic therapy results, clinical and functional scores,<br />
duration of surgery, and the type of implant. Due to the restricted number of<br />
revision surgery because of aseptic loosening, we used radiological signs of<br />
component loosening (RCL) as a more sensitive surrogate outcome parameter<br />
for our main analysis. These included radiolucent lines (RLL) with a width<br />
of ≥2mm, osteolysis exceeding 2mm in thickness, and implant migration of<br />
≥2mm. Two independent observers, who were blinded for levels of disease ac-
TOP-Studien<br />
31<br />
Aseptic loosening is the most common<br />
cause for surgical revision after TJA with<br />
far-reaching implications.<br />
„Inflammation in RA patients, as<br />
evidenced by higher levels of disease<br />
activity, increases the risk for radiographic<br />
loosening after TJA. In OA<br />
patients, as a control disease without<br />
systemic inflammation, the risk is<br />
significantly lower.“<br />
Christoph Böhler<br />
tivity and the clinical diagnosis (OA/RA), evaluated the radiographs. Patients<br />
were seen after 6 weeks, 3 and 12 months, and then annually after the TJA.<br />
The Simplified Disease Activity Index (SDAI) was used to determine disease<br />
activity levels. At our rheumatology outpatient clinic, RA patients are followed<br />
every 3 months, and their clinical and laboratory variables are documented<br />
prospectively in an observational database. For statistical analysis we<br />
performed Cox regression to estimate RCL based on SDAI, adjusting for the<br />
anti-rheumatic therapy (conventional vs. biological disease modifying drugs,<br />
DMARDs). Furthermore, we compared the rates of aseptic loosening and RCL<br />
in RA and OA patients using the Chi-Square-Test, the Kaplan Meier method,<br />
and applied the Log-Rank test to statistically compare survival distributions.<br />
Results<br />
32 patients (65.3%) underwent TKA, and 17 (34.7%) THA. All TKA were<br />
cemented and all THA were fixated cementless. In total 18 (36.7%) showed<br />
signs of RCL. Time integrated SDAI was significantly higher in patients with<br />
RCL (median; 25th and 75th percentile: 10.8; 8.6 and 15.8) than in controls<br />
without RCL (7.0; 2.7 and 15.5) (Figure 1; p=0.043).<br />
When comparing RCL across patient groups in different RA disease activity states,<br />
we found that in the remission group no patient showed signs of RCL (0/10),<br />
whereas in the low and moderate/high disease activity groups 10/21 (47.6%)<br />
and 8/17 (47.1%) patients, respectively, showed signs of RCL (p=0.023). RA<br />
patients receiving biologicals had clearly lower rates of RCL (4/18; 22.2%) compared<br />
to RA patients under traditional DMARD therapy (14/28; 50%). In logistic<br />
regression analyses biologicals significantly reduced the risk of RCL with an<br />
odds ratio (OR) of 0.192 (95% CI 0.042-0.891; p=0.035). The RCL rate was 36.7%<br />
in the RA group and 13.6% in the OA group (p=0.002). This was mainly explained<br />
by a higher rate of RCL in the TKA group (RA: 34.4%; OA: 6.5%; p=0.001), while<br />
the rates in the THA group were only numerically higher in patients with RA<br />
compared to OA (41.2% vs. 30.8%, respectively; p=0.528).<br />
Discussion<br />
The current study for the first time links the risk of aseptic loosening in RA<br />
patients to the level of inflammation with higher disease activity being associated<br />
with more frequent occurrence of radiographic loosening. Biological
TOP-Studien<br />
32<br />
Figure 1: Time integrated SDAI was significantly<br />
higher in patients with RCL (median; 25th and 75th<br />
percentile: 10.8; 8.6 and 15.8) than in controls<br />
without RCL (7.0; 2.7 and 15.5) (Figure 1; p=0.043).<br />
DMARDs had a protective effect on such risk. This link between inflammation<br />
and RCL was further substantiated in the comparison between RA and OA,<br />
being particularly evident for TKA.<br />
Priv.-Doz. DDr. Christoph Böhler<br />
Author:<br />
Christoph Böhler is a specialist<br />
for Orthopaedics and Traumatology<br />
at the Medical University of<br />
Vienna. His clinical and scientific<br />
focus are on primary and<br />
revision arthroplasty. In August<br />
2021 he will start a clinical<br />
Adult Reconstruction Fellowship<br />
at the University of Toronto,<br />
Canada.<br />
Local inflammation plays a pivotal role in the pathogenesis of aseptic loosening,<br />
by which generation of wear debris between the bearing surfaces<br />
leads to activation of macrophages and immune cells, which then release<br />
pro-inflammatory cytokines like TNF-alpha and IL-6. These induce osteoclast<br />
activation and lead to increased bone resorption, osteolysis and eventually to<br />
aseptic loosening. The systemic inflammation of RA may play a role in enhancing<br />
the local inflammation underlying the described processes leading to<br />
aseptic loosening. The implication of these findings for clinical practice are<br />
potentially substantial, at least for individuals with RA and TJA: no patients<br />
in remission showed RCL. Analogously to the observation that in sustained<br />
remission of RA joint damage does not progress, this makes the case that<br />
in the presence of TJA even stricter disease control should be pursued, with<br />
clinical remission being the clear treatment target. Biological DMARDs had<br />
a protective effect on the risk of RCL. Previously, it has been shown that<br />
TNF-inhibitors are able to stop the progression of joint destruction. The<br />
majority of the patients in the biological DMARDs group were treated with<br />
TNF-inhibitors, potentially also suggesting a role of TNF alpha in the mediation<br />
of the inflammatory process leading to aseptic loosening.<br />
Conclusion<br />
Taken together, inflammation in RA patients, as evidenced by higher levels<br />
of disease activity, increases the risk for radiographic loosening after TJA. In<br />
OA patients, as a control disease without systemic inflammation, the risk is<br />
significantly lower. Biological DMARDs may reduce the risk of RCL, although<br />
this would need prospective evaluation. Our data suggest that RA patients<br />
with TJA should regularly undergo orthopaedic and radiographic evaluation<br />
and, in the context of treating RA to target, might be considered for a more<br />
stringent control of disease activity.
Integriertes Patientenversorgungskonzept zur MACT-<br />
Gelenksknorpelrekonstruktion<br />
Exakte Indikationsstellung<br />
Indikations- und Durchführungs empfehlungen<br />
der Arbeits gemeinschaft „Geweberegeneration<br />
und Gewebe ersatz“ zur Autologen<br />
Chondrozyten-Transplanta tion (ACT). Behrens<br />
P, Bosch U, Bruns J, Erggelet C, Esenwein SA, Gaissmaier<br />
C, Krackhardt T, Löhnert J, Marlovits S, Meenen NM,<br />
Mollenhauer J, Nehrer S, Niethard FU, Nöth U, Perka C,<br />
Richter W, Schäfer D, Schneider U, Steinwachs M, Weise K<br />
(2004). Z Orthop 142: 529-539<br />
Hohe Zelldichte und hohe Zellvitalität<br />
des Implantats<br />
Effect of cell seeding concentration on the quality<br />
of tissue engineered constructs loaded with adult<br />
human articular chondrocytes. Concaro S, Nick lasson E,<br />
Ellowsson L, Lindahl A, Brittberg M, Gatenholm P (2008).<br />
J Tissue Eng Regen Med<br />
Flexible Anpassung des Implantats bei<br />
der Trans plantation und Wahrung einer<br />
homogenen Zellmatrix<br />
Stabilization of fibrin-chondrocyte constructs for<br />
cartilage reconstruction. Meinhart J, Fussenegger M, Höbling W<br />
(1999), Ann Plast Surg 42(6): 673-678<br />
KnorpelbiobsatEntnahme<br />
Zellkultur züchten<br />
MACTTransplantation<br />
Seit 2001 züchtet das Institut<br />
für Gewebe- und Organrekonstruk<br />
tion, kurz igo®,<br />
autologe Zell kul turen für die<br />
Knorpel zell rekon struk tion für mehr als 1.500 Patienten<br />
erfolgreich an.<br />
igo® ist ein privates biopharmazeutisches Unternehmen<br />
und Pionier auf dem Gebiet der Zellkulturtechnik<br />
und des Tissue Engineerings und aktiv<br />
beteiligt an Entwicklung neuer Heilmethoden. Als<br />
österreichisches Unternehmen glänzen wir mit<br />
der besonderen räumlichen Nähe und dem direkten<br />
Kontakt zu unseren Kunden.<br />
Informieren Sie sich unter www.igor.at<br />
Hohe Compliance des Patienten: Die für<br />
die Nachtherapie verwendeten Geräte,<br />
CPM Schiene sowie HPM Gerät verfügen<br />
über eine ComplianceÜberwachung. Wenn<br />
der Patient hier compliant ist, kann man<br />
davon ausgehen, dass er auch bei der<br />
Physio therapie konsequent mitarbeitet, was<br />
für den Erfolg der Therapie wesentlich ist.<br />
Low frequency EMF regulates chondrocyte<br />
differentiation and expression of matrix proteins.<br />
Ciombor DM, Lester G, Aaron RK, Neame P, Caterson B (2002).<br />
J Orthop Res, Vol. 20(1): 40-50<br />
Postoperative Therapie<br />
Die Kontrollierte Nachtherapie: wird<br />
durch das Netz werk von geschulten Physiotherapeuten<br />
unterstützt<br />
MACTLangzeittherapie<br />
Autologous chondrocyte implantation postoperative<br />
care and rehabilitation. Hambly K, Bobic V, Wondrasch B,<br />
VanAssche D, Marlovits S (2006). Science and Practice.<br />
Am J Sports Med 34(6): 1020-1038<br />
A prospective, randomized comparison of traditional<br />
and accelerated approaches to postoperative<br />
rehabilitation following autologous chondrocyte<br />
implantation: 2-year clinical outcomes. Jay R. Ebert,<br />
William B. Robertson, David G. Lloyd, M.H. Zheng, David J. Wood,<br />
Timothy Ackland (2010). Catilage 1(3)180-187<br />
Wissenschaftliche Publikationen<br />
mit igor ChondroSystems<br />
Clinical experience with matrix associated<br />
autologous chondrocyte transplantation<br />
(MACT). Ramadani F, Orthner E, Kitzler B,<br />
Wallner B, Burghuber C, Fußenegger M, Meinhart J<br />
(2005). Revista de ortopedie si traumatologie 1(6):<br />
106-110<br />
Transplantation of chondrocytes – longtime<br />
experiments. Prof. Dr. Lars Peterson (2006)<br />
Ergebnis nach ca. 18 Monaten<br />
Quelle:<br />
<strong>Klinik</strong> Diakonissen<br />
Schladming<br />
Seit 2006 läuft das Koopera ti onsprojekt Leomed/<br />
Igor der integrierten Patientenver sorgung für<br />
Knor pel rekon struktion.<br />
Nach Implantation unterstützt Leomed die<br />
Patienten bei der Organisation der Nachtherapie.<br />
Informieren Sie sich unter www.leomed.at
TOP-Studien<br />
34<br />
OSTEOGROW: Acceleration<br />
of Bone Healing<br />
Study:<br />
Chiari C, Grgurevic L, Bordukalo-Niksic<br />
T, Oppermann H,<br />
Valentinitsch A, Nemecek E,<br />
Staats K, Schreiner M, Trost C,<br />
Kolb A, Kainberger F, Pehar S,<br />
Milosevic M, Martinovic S, Peric<br />
M, Sampath TK, Vukicevic S,<br />
Windhager R. Recombinant<br />
Human BMP6 Applied Within<br />
Autologous Blood Coagulum<br />
Accelerates Bone Healing:<br />
Randomized Controlled Trial<br />
in High Tibial Osteotomy<br />
Patients. J Bone Miner Res.<br />
<strong>2020</strong> Oct;35(10):1893–1903.<br />
The presented study was undertaken within the OSTEOGROW<br />
collaborative project and has received funding from the European<br />
Union’s Seventh Framework Programme for research, technological<br />
development, and demonstration under grant agreement<br />
No. 279239. The Department of Orthopedics at the Medical University<br />
of Vienna (MUV) served as the study site for the clinical<br />
study on a first in human application of recombinant BMP-6<br />
(bone morphogenic protein – 6).<br />
Prof. Reinhard Windhager (principal investigator) and Prof. Catharina Chiari<br />
(sub-investigator) were the responsible scientists at the MUV. The international<br />
consortium was coordinated by Prof. Slobodan Vukicevic (University of<br />
Zagreb), who is a renowned expert in the field of BMP research.
TOP-Studien<br />
35<br />
Figure 1: Bone mineral density (BMD) measurements.<br />
BMD measured in the wedge of two<br />
groups of high tibial osteotomy (HTO) patients<br />
(autologous bone graft substitute [ABGS] and<br />
placebo [PBO]) from baseline (measured before<br />
the treatment) to weeks 9 and 14 after surgery.<br />
BMD values in the reference cube at baseline<br />
and weeks 9 and 14 after surgery.<br />
„First in human application of rhBMP-6<br />
in high tibial osteotomy for the acceleration<br />
of bone healing.“<br />
Catharina Chiari<br />
The Study<br />
Recombinant human bone morphogenetic proteins (rhBMPs) 2 and 7 have<br />
been used in the treatment of long bone fractures in conjunction with<br />
bovine collagen matrices. They showed side effects like redness and<br />
swelling and induction of osteolysis in cancellous bone, i.e., metayphyis<br />
of the tibia, radius, and hip 1 . Therefore, this project aimed to develop a<br />
rh-BMP-based therapy with a carrier made from autologous blood. This<br />
novel autologous bone graft substitute (ABGS) was composed of rhBMP6<br />
applied within autologous blood coagulum (ABC) 2 . In the present study,<br />
we assessed intraosseal administration of ABGS, i.e., rhBMP (rhBMP6)<br />
loaded within autologous blood coagulum in adult patients who underwent<br />
a high tibial osteotomy (HTO). This study was a randomized, double-blind,<br />
and placebo-controlled phase I/II trial. The primary objective of the study<br />
was to assess safety, tolerability, anti-BMP6 antibody response, if any, and<br />
systemic pharmacokinetics (PK) of the application 100 μg rhBMP6/mL ABC<br />
locally into the wedge gap after osteotomy. The secondary objective was to<br />
assess the acceleration of bone healing in the wedge gap. The total number of<br />
patients enrolled was 20 with a final assignment ABGS/PBO 1:1, 6 included<br />
in phase I and 14 in phase II.
TOP-Studien<br />
36<br />
Figure 2: X-ray images of isolated defect areas<br />
from 2 patients treated with autologous bone<br />
graft substitute (ABGS) or placebo (PBO) from day<br />
1 to month 24. Black arrows shown for the defect<br />
area at month 18 indicate more pronounced BMD<br />
on X-rays of a PBO-treated patient compared with<br />
ABGS. However, at 12 months, still there is a gap<br />
in zone 4 (Z4) for both groups as shown on X-ray<br />
images. At month 24, in the medial site of the gap<br />
for both groups, an incomplete cortical-periosteal<br />
surface restoration after plate removal is indicated<br />
(yellow arrows).<br />
Our Patients<br />
Patients were followed for 0 to 24 months by clinical examination (safety),<br />
computed tomography (CT), and serial radiographic analyses (efficacy) 3 .<br />
The results showed no detectable anti-rhBMP6 antibodies in the blood of<br />
any of the 20 patients at 14 weeks after implantation. During the following<br />
24 months no serious adverse reactions were recorded. The CT scans from<br />
defects of patients treated with rhBMP6/ABC showed an accelerated bone<br />
healing compared with placebo at 9 weeks (47.8 ± 24.1 versus 22.2 ± 12.3<br />
mg/cm 3 ; p = 0.008) and at 14 weeks (89.7 ± 29.1 versus 53.6 ± 21.9 mg/cm 3 ;<br />
p = 0.006) follow-up (Figure 1). Radiographic analyses at weeks 6 and 24 and<br />
months 12 and 24 suggested the advanced bone formation and remodeling<br />
in rhBMP6/ABC-treated patients (Figure 2).<br />
Conclusion<br />
We were able to show that rhBMP6/ABC at a dose of 100 μg/mL accelerates<br />
bone healing in patients undergoing HTO without serious adverse events<br />
and with good tolerability compared with placebo alone. For the first time,<br />
a BMP-based osteogenic implant was examined against a placebo for bone<br />
healing efficacy in the trabecular bone surface, using an objective bone<br />
mineral density measurement system.<br />
ao. Univ.-Prof. in Dr. in Catharina Chiari, MSc<br />
Author:<br />
Catharina Chiari is head of the<br />
Pediatric Orthopedic Team.<br />
Additionally, she has a strong<br />
interest in joint preservation<br />
and regenerative medicine.<br />
Currently she is the president<br />
elect of the Austrian Orthopedic<br />
Society (ÖGO).<br />
References:<br />
1<br />
Vukicevic S, Sampath TK. Bone morphogenetic proteins: systems biology regulators. 1st ed. New<br />
York: Springer International Publishing; 2017.<br />
2<br />
Grgurevic L, Oppermann H, Pecin M, Erjavec I, Capak H, Pauk M, Karlovic S, Kufner V, Lipar M,<br />
Bubic Spoljar J, Bordukalo-Niksic T, Maticic D, Peric M, Windhager R, Sampath TK, Vukicevic S.<br />
Recombinant human bone morphogenetic protein 6 delivered within autologous blood coagulum<br />
restores critical size segmental defects of ulna in rabbits. JBMR Plus. 2019;3(5):e10085.<br />
3<br />
Nemecek E, Chiari C, Valentinitsch A, Kainberger F, Hobusch G, Kolb A, Hirtler L, Trost C, Vukicevic<br />
S, Windhager R. Analysis and quantification of bone healing after open wedge high tibial osteotomy.<br />
Wien Klein Wochenschr. 2019;131(23–24):587–98.
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A Prediction Model for<br />
Total Knee Arthroplasty<br />
A collaborative group of researchers consisting of clinicians,<br />
biostatisticians and anatomists initiated this study in order to<br />
determine patient specific factors that could predict whether a<br />
patient will have to undergo Total Knee Arthroplasty (TKA) within<br />
two years. This work resulted in the establishment of an easily<br />
applicable prediction model based on Artificial Neural Networks<br />
(ANN), as well as in a publication entitled „Predicting Total Knee<br />
Replacement from Symptomology and Radiographic Structural<br />
Change Using Artificial Neural Networks—Data from the Osteoarthritis<br />
Initiative (OAI)“ in the Journal of Clinical Medicine 1 .<br />
As our clinic is a well renowned excellence center for total joint arthroplasty<br />
(EndoCert), we are constantly concerned with improving patient care<br />
by ongoing research. Considering the crucial role of timing of TKA, as well<br />
as the progression of osteoarthritis as the underlying disease, we aimed to<br />
determine factors that could predict TKA two years in advance. In this effort<br />
clinicians from our department teamed up with a biostatistics professor<br />
from Paracelsus Medical University and an anatomy professor from Mayo<br />
Clinic College of Medicine. By using artificial neural networks we succeeded<br />
to establish a prediction model that was able to correctly predict 80%<br />
of the classified individuals to undergo TKA surgery, with a positive predictive<br />
value of 84% and a negative predictive value of 73% 1 .<br />
As commonly known, osteoarthritis of the knee contributes significantly to<br />
the patient’s individual disability and impaired health-related quality of life,<br />
and its treatment imposes a great socioeconomic burden, which is likely to<br />
increase further, as we have shown in a previous study 2 .<br />
Study:<br />
Heisinger S, Hitzl W, Hobusch<br />
GM, Windhager R, Cotofana S.<br />
Predicting Total Knee Replacement<br />
from Symptomology<br />
and Radiographic Structural<br />
Change Using Artificial<br />
Neural Networks-Data from<br />
the Osteoarthritis Initiative<br />
(OAI). J Clin Med. <strong>2020</strong> May<br />
1;9(5):1298.<br />
Patients and Methods<br />
In this study we included the radiographic and clinical data of 165 patients that<br />
were enrolled in the Osteoarthritis Initiative study, representing a well-established<br />
database for osteoarthritis research, which is accessible at nda.nih.gov 3 .<br />
Patient data were analyzed longitudinally and changes were identified as<br />
shown in Figure 1 (WOMAC total: 9.7 95% CI (7–12.5), p = < 0.0001; WOMAC<br />
pain subscore: 0.5 (1.5–3), p = < 0.0001; quality of life 9.4 (6.3–12.6), p = <<br />
0.0001; and pain intensity 1.5 (1–2), p = < 0.0001 ). While the radiographic<br />
status constantly worsened between the timepoints prior to TKA, the symptomology<br />
started to significantly worsen 1 year before surgery. In order to<br />
develop a prediction model we used Artificial neural networks (ANNs) 1 .
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Figure 1: Longitudinal change of WOMAC totalscore, WOMAC pain subscore,<br />
quality of life and pain intensity.<br />
„Our model is based on easily accessible<br />
patient data, making it easily applicable<br />
in a primary care setting to evaluate the<br />
need for TKA surgery within the next<br />
two years and to give the patient an idea<br />
about their status quo.“<br />
Stephan Heisinger<br />
In total 14 variables were included, and the most predictive group consisting<br />
of pain intensity, Kellgren and Lawrence grades, WOMAC total score, use of<br />
pain medication, and body mass index was identified by the integrated neural<br />
network variable selection algorithm to have the best outcome performance<br />
for predicting TKA surgery within 2 years. Furthermore, more than 250 neural<br />
networks models with different network architecture were created, tested,<br />
and protected against overlearning by splitting the patient sample into a<br />
training, a verification, and a test sample, and monitored accordingly (ratio<br />
2:1:1). We used two prediction thresholds for acceptance and for rejection,<br />
i.e., if data of a subject fall into this area, no prediction is made. All analyses<br />
were done using PASW 22 (IBM SPSS Statistics for Windows, Version 19.0.,<br />
Armonk, NY, USA), StatXact 10 (Cytel Software 2013, Cambridge MA, USA),<br />
Mathematica 7 (Wolfram Research, Inc., Mathematica, Version 7.0, Champaign,<br />
IL, USA), STATISTICA for neural networks 1.2 and STATISTICA 13 (Hill, T. &<br />
Lewicki, P. Statistics: Methods and Applications. StatSoft, Tulsa, OK, USA) 1 .<br />
After the application of the variable selection algorithm and testing more<br />
than 250 models, KL grades, WOMAC total score, body mass index measures,<br />
pain intensity, and pain medication revealed the following performance: a<br />
negative predictive value of 73% (52–88%), a positive predictive value of<br />
84% (71–94%), and total percentage of correctly predicted knees of 80%<br />
(69–89%) (1). To graphically visualize the neural network output and thereby<br />
our prediction model we created a simplified and easily applicable chart, as<br />
depicted in Figure 2.
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Figure 2: Graphic visualization of the neural network output illustrating the three-layer perceptron decision areas, including the variables pain intensity,<br />
Kellgren and Lawrence grades, WOMAC total score, use of medication (for pain, aching, or stiffness in the knee), and body mass index into the neural<br />
network. Areas represent: green area = no TKA within next 2 years, red area = TKA within next 2 years, and grey area = no prediction is made (1).<br />
Results and Conclusion<br />
Concludingly, our results indicate that significant worsening of pain, function,<br />
and quality of life in the year prior to the TKA seems to be the more dominant<br />
decision driving factor as compared to the radiographic structural changes<br />
of the knee. Furthermore, we were able to establish a model that correctly<br />
predicted 80% of the classified individuals to undergo TKA surgery within the<br />
next 2 years, with a positive predictive value of 84%, and a negative predictive<br />
value of 73% 1 . Our model is based on easily accessible patient data,<br />
making it easily applicable in a primary care setting to evaluate the need for<br />
TKA surgery within the next two years and to give the patient an idea about<br />
their status quo.<br />
Dr. Stephan Heisinger<br />
Author:<br />
Stephan Heisinger completed<br />
his residency at the Department<br />
of Orthopedics and Trauma Surgery<br />
at the Medical University of<br />
Vienna and is currently engaged<br />
in a broad variety of research<br />
fields with a focus on the<br />
application of novel research<br />
tools, such as Artificial Neural<br />
Networks.<br />
References:<br />
1<br />
Walzer SM, Toegel S, Chiari C, Farr S, Rinner B, Weinberg AM, Weinmann D, Fischer MB, Windhager<br />
R.; A three dimensional model of zonally organized cartilaginous matrix in vitro. (in submission)<br />
2<br />
Kolb A, Robinson S, Stelzeneder D, Schreiner M, Chiari C, Windhager R, Trattnig S, Bohndorf K;<br />
Vessel architecture in human knee cartilage in children: an in vivo susceptibility-weighted<br />
imaging study at 7 T; Eur Radiol. 2018 Aug;28(8):3384-3392. doi: 10.1007/s00330-017-5290-1.<br />
Epub 2018 Feb 26.<br />
3<br />
Kolb A, Benca E, Willegger M, Puchner SE, Windhager R, Chiari C.; Measurement considerations on<br />
examiner-dependent factors in the ultrasound assessment of developmental dysplasia of the hip;<br />
Int Orthop. 2017 Jun;41(6):1245–1250.(2)
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tPA Serum Antigen Levels Predict<br />
ARDS in Polytraumatized Patients<br />
Acute respiratory distress syndrome (ARDS) is a highly lifethreatening,<br />
clinically defined, heterogeneous condition, regarding<br />
both etiology and clinical course, which is triggered by<br />
either a direct or an indirect insult to the lung, causing epithelial<br />
and endothelial injuries. A variety of cellular and molecular<br />
mechanisms contribute to the complex pathophysiology of ARDS,<br />
including inflammation-induced coagulation and reduced fibrinolysis,<br />
which favor excessive intra-alveolar fibrin deposition.<br />
„The choice of the right treatment<br />
strategy for polytraumatized patients<br />
has to be based on an individual<br />
risk stratification. The ambition of<br />
contributing to the implementation<br />
of a personalized polytrauma care<br />
encouraged me to establish the<br />
research group ‚Biomarkers‘ in 2011.“<br />
Lukas Negrin<br />
Study:<br />
Negrin LL, Dedeyan M, Plesser<br />
S, Hajdu S. Impact of Polytrauma<br />
and Acute Respiratory<br />
Distress Syndrome on Markers<br />
of Fibrinolysis: A Prospective<br />
Pilot Study. Front Med<br />
(Lausanne). <strong>2020</strong> Jun 2;7:194.<br />
ARDS is a common complication in polytrauma victims, particularly in<br />
those with chest injuries, and a major cause of mortality and morbidity.<br />
Its development is difficult to anticipate, as candidate biomarkers for the<br />
prediction of ARDS were found not to be reliable for clinical use. By assessing<br />
the time-dependent course of the serum antigen levels of the tissue<br />
plasminogen activator (tPA) and the plasminogen activator inhibitor type-1<br />
(PAI-1), which are both thought to reflect endothelial damage, we strived to<br />
identify a cut off value or a clear curve characteristic that might predict the<br />
development of ARDS in polytraumatized patients.<br />
Our prospective study enrolled 28 consecutive blunt polytrauma survivors<br />
(mean age, 38.4 [18-85] years; mean ISS, 35.1 [21-50]), who were directly<br />
admitted to our level I trauma center within one year and transferred to the<br />
ICU after initial treatment fulfilling the inclusion criteria minimum age of 18<br />
years (1), Injury Severity Score (ISS) equal or higher than 16 (2), no anticoagulant<br />
medication before trauma (3), and no treatment with tranexamic acid<br />
(4) to avoid hyperfibrinolysis. To investigate the natural history of biomarker<br />
levels, blood samples for tPA and PAI-1 analysis using Luminex multi-analyte<br />
technology were taken at admission (day 0) and on days 1, 3, 5, 7, 10, 14,<br />
and 21 during hospitalization, as long as the patient consented. Ten healthy<br />
adults, who had responded our call for volunteers, were combined to our<br />
control group. Only one blood sample was taken from them. Mann-Whitney<br />
U-test, Chi-square test, and Wald test were performed to reveal significant<br />
differences (p 3-fold higher than the mean level of the healthy control<br />
group. After decreasing by 36% from day 0 to day 3 (p = 0.004), it basically<br />
remained stable for up to 21 days (included).
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Figure 1: Individual tPA antigen levels<br />
(grey lines) and mean tPA antigen level<br />
(black bold line) in the study group.<br />
Mean ± standard error of the mean<br />
of tPA in healthy controls (green).<br />
tPA is secreted into the plasma primarily by vascular endothelial cells through<br />
two pathways: consecutive secretion, in which proteins are continuously<br />
released as fast as they are synthesized, and regulated secretion, in which<br />
newly synthesized tPA is stored at high concentrations in organelles and<br />
secreted only in response to an appropriate stimulus such as a vascular injury.<br />
We speculate that the physical impact at the time of injury and pathophysiological<br />
processes hereafter might trigger enhanced consecutive secretion,<br />
causing a long-term increase in biomarker levels, whereas regulated secretion<br />
might further raise this „steady-state“ level for a short period in response to<br />
additional endothelial damage.<br />
At day 0 the mean PAI-1 antigen level was 2.6-fold higher than that of healthy<br />
controls. Despite the 20% decrease from day 0 to day 5 (p = 0.007), it remained<br />
elevated for at least three weeks. Mean PAI-1 antigen levels were higher in<br />
poly trauma victims developing pneumonia compared to those not developing<br />
the complication. The Wald test calculated p = 0.128 and 0.044 for the first<br />
week and first three weeks from admission, respectively. Noteworthy, PAI-1<br />
antigen levels increased between day 7 and day 10 in ten of 12 patients sustaining<br />
pneumonia, all ten patients also suffering from ARDS.<br />
A strong positive correlation between tPA and PAI-1 antigen levels within<br />
the first week post-trauma was revealed, indicating that tPA and PAI-1<br />
synthesis and their clearance from circulation by hepatic cells might be biologically<br />
linked. The significant subject correlation over time between each<br />
pair of tPA antigen levels might be explained by a predominant consecutive<br />
secretion, ensuring high continuity in tPA antigen levels. Contrarily, correlation<br />
coefficients between PAI-1 antigen levels were only significant in some
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Figure 2: tPA antigen levels (mean ± standard<br />
error of the mean) in a subgroup of patients with<br />
ARDS (ARDS 1 black bold line) and a subgroup<br />
with no ARDS (ARDS 0, gray bold line). * indicates<br />
significant difference between ARDS 1 and ARDS<br />
0 group. Mean ± standard error of the mean of tPA<br />
in healthy controls (green).<br />
cases, which might be explained by its regulated secretion from platelets<br />
caused by post-trauma triggers, as they vary between individuals.<br />
Priv.-Doz. Dr. Lukas L. Negrin, PhD, MSc<br />
Author:<br />
Lukas Negrin has been working<br />
as a specialist in trauma surgery<br />
at the University Department<br />
for Orthopedics and Trauma<br />
Surgery since 2016. He completed<br />
his habilitation in 2018<br />
and deepened his knowledge<br />
through numerous stays abroad.<br />
His main focus lies on severely<br />
injured and polytraumatized<br />
patients, having already drawn<br />
his interest early on during<br />
his career. Currently he is the<br />
head of the interdisciplinary<br />
working group „Biomarkers in<br />
polytrauma“, the head of the<br />
research cluster „Polytrauma<br />
and traumatic brain injury“, and<br />
deputy head of the task force<br />
„Polytrauma“ of the Austrian<br />
Society for Trauma Surgery.<br />
In our study group 11 patients developed ARDS (mean age, 29.7 [18-48]<br />
years; mean ISS, 35.1 [29-50]), whereas 17 patients (mean age, 44.0 [18-85]<br />
years; mean ISS, 33.7 [21-50] remained unaffected. As displayed in Figure 2,<br />
the mean tPA antigen level was higher in polytraumatized patients developing<br />
ARDS (group ARDS 1) than in those without ARDS (group ARDS 0) for<br />
the entire observation period. A significant difference in tPA antigen levels<br />
was observed at day 1 (p = 0.020), which was confirmed by the Wald test<br />
(p = 0.004 for the period from day 0 to day 7 and p = 0.007 for the period from<br />
day 0 to day 21).<br />
Conclusion<br />
Nevertheless, tPA antigen levels at days 0 and 1 were not suitable to predict<br />
ARDS, as the levels observed at these days presented high variance due to<br />
the different individual injury patterns. Particularly noticeable, however, is<br />
the fact that in each polytrauma victim developing ARDS, the tPA antigen level<br />
steadily increased or suffered a second increase up to the onset of the syndrome,<br />
decreasing immediately thereafter. As each increase in tPA antigen<br />
levels during hospitalization may indicate the imminent development of ARDS,<br />
it should be considered as a warning sign for the timely implementation of<br />
effective therapies that can prevent or at least weaken the manifestation of<br />
the syndrome. Our findings indicate the potential of serum tPA antigen, when<br />
repeatedly assessed, as a reliable biomarker to identify polytraumatized<br />
patients at high risk of developing this syndrome. This approach is not only<br />
cost- and resource-effective, but can also be easily implemented in the clinic<br />
by using bedside tests. If included in the routine of daily blood sampling and<br />
analysis, the assessment of tPA antigen levels would not result in significant<br />
additional work and expenses.
3D Biochips for Research on<br />
Inflammatory Musculoskeletal<br />
Diseases<br />
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In <strong>2020</strong>, a cooperative project of researchers of the „Karl Chiari Lab<br />
for Orthopaedic Biology“, co-coordinated with the „Division of<br />
Rheumatology“, and the CellChipGroup at the Vienna University<br />
of Technology developed a lab-on-a-chip system for analysis<br />
of tissue-level remodeling in arthritic synovium, resulting in<br />
the article entitled „Monitoring Tissue-Level Remodeling during<br />
Inflammatory Arthritis Using a Three-dimensional Synoviumon-a-Chip<br />
with Non-invasive Light Scattering Biosensing“ in RSC<br />
Lab on a Chip (IF: 6.774). The work is a result of years of interdisciplinary<br />
research at the interface of basic biological research<br />
and bioengineering.<br />
Study:<br />
Rothbauer M, Höll G, Eilenberger<br />
C, Kratz SRA, Farooq<br />
B, Schuller P, Olmos Calvo I,<br />
Byrne RA, Meyer B, Niederreiter<br />
B, Küpcü S, Sevelda F,<br />
Holinka J, Hayden O, Tedde<br />
SF, Kiener HP, Ertl P. Monitoring<br />
tissue-level remodelling<br />
during inflammatory arthritis<br />
using a three-dimensional<br />
synovium-on-a-chip with<br />
non-invasive light scattering<br />
biosensing. Lab Chip. <strong>2020</strong><br />
Apr 21;20(8):1461-1471. doi:<br />
10.1039/c9lc01097a<br />
Since 2019, the study of musculoskeletal tissues in microfluidic biochips is<br />
a new additional research focus of tissue engineer Dr. Mario Rothbauer at<br />
the „Karl Chiari Lab for Orthopedic Biology“ (KCLOB) of the Department of<br />
Orthopedics and Trauma Surgery. The biochip team wants to use organotypic<br />
tissue-like microsystems as three-dimensional disease models of the human<br />
joint to recapitulate onset and progression of degradative and inflammatory<br />
processes in arthritic diseases including rheumatoid arthritis (RA) and<br />
osteoarthritis (OA), ranging from molecular pathways up to cellular and<br />
tissue-level architecture and communication.<br />
A systematic in vitro investigation of disease factors and co-factors that<br />
mediate arthritic diseases, using three-dimensional human organotypic<br />
biochips, may be key in identifying basic biological processes that govern<br />
the onset and progression of musculoskeletal diseases. As active member<br />
of the European Society for Alternatives to Animal Experiments (EUSAAT),<br />
Dr. Rothbauer aims at a patient-derived approach for his team’s basic and<br />
applied research, focusing on complimentary or even alternative methods to<br />
animal experiments that include, i.e., the well-established collagen-induced<br />
or collagen-antibody-induced rodent models (CIA/CAIA). The challenging<br />
project idea to establish an animal-product-free synovial organoid biochip<br />
platform for drug screening was awarded in 2019 with the Herbert Stiller<br />
Prize of the Doctors Against Animal Experiments Association. 1<br />
For several years, Dr. Rothbauer has focused on the development of microphysiological<br />
sensor-integrated microsystems (i.e., microvasculature, blood brain<br />
barrier, placenta) 2-4 , with special attention on synovium as inflammatory tissue
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3D Synovium-on-a-chip with scattering biosensing.<br />
„Researchers were able to develop a<br />
non-invasive lab-on-a-chip system for<br />
the modelling of architectural changes<br />
inside RA patient-derived synovial<br />
organoids during inflammatory<br />
remodeling. This constitutes as a<br />
major technological advance as the<br />
study presents the first translation<br />
of human synovium organoids into<br />
a miniaturized biochip format.“<br />
Mario Rothbauer<br />
in arthritic disease modelling. Currently his team is expanding this technological<br />
platform for other musculoskeletal structures, including osteochondral,<br />
adipose, and fibrous tissues. Essentially, patient-derived tissue microsystems<br />
comprise microfluidic microchannels, isolated primary patient cells (i.e.,<br />
fibroblast-like synoviocytes, chondrocytes, fibroblasts, or adipocytes), and<br />
three-dimensional hydrogels as scaffolding material. In contrast to bioprinting,<br />
where the basic shape is defined a priori by the printing technique, the microsystems<br />
of the KCLOB form complex tissue-like structures resembling patient<br />
joint tissues solely by the patient cells’ potential to remodel a bulk scaffold and<br />
organize themselves into functional tissue-like structures.<br />
Development of a Non-invasive Lab-on-a-chip System<br />
Based on almost a decade of collaborative synovium-on-a-chip development,<br />
basic researchers at the „Karl Chiari Lab for Orthopaedic Biology“<br />
and the „Division of Rheumatology“ joined forces with Vienna University of<br />
Technology, the University of Natural Resources and Life Sciences (BOKU),<br />
and the TranslaTUM of Technical University of Munich, to develop a non-invasive<br />
lab-on-a-chip system for the modelling of architectural changes inside<br />
RA patient-derived synovial organoids during inflammatory remodeling. This<br />
constitutes as a major technological advance as the study presents the first<br />
translation of human synovium organoids into a miniaturized biochip format.<br />
It demonstrated the formation of synovial organoids by in situ polymerization of<br />
hydrogel with a high degree of position accuracy as well as a more reproducible<br />
environment for organoid reorganization. Time-resolved light scattering<br />
signals of 3D synovial organoids subjected to a TNF-α-mediated inflammatory<br />
stimulus showed a significant scatter signal increase of 16% and<br />
21% already at day 3 and 4, respectively. These alterations in light scattering<br />
are a direct result of the structural and architectural changes within the<br />
inflamed synovial organoid, featuring Cadherin-11-mediated thickening of<br />
the synovial lining as well as the cellular network structures of the synovial<br />
sublining with a strong Interleukin-6 and Interleukin-8 response.<br />
Further Findings<br />
The basic approach of combining multiple self-organizing biochip organoids<br />
for crosstalk studies is currently under investigation for molecular RA and OA<br />
research. While microfluidic models recapitulating molecular aspects of bone
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Chondro-Synovial Crosstalksing.<br />
erosion between bone-derived cells and synoviocytes have been established,<br />
RA’s synovial-chondral axis has not been realized using a microfluidic 3D<br />
model based on human patient cells in vitro. Consequently, our collaborative<br />
team has established a chip-based three-dimensional tissue co-culture model,<br />
simulating the reciprocal crosstalk between individual synovial and chondral<br />
organoids. Preliminary results recently published as BioRxiv preprint 5 already<br />
indicate differential dynamics of organoid formation and remodeling in<br />
co-cultures of chondro-synovial organoids. Particularly, a chondral organoid<br />
in co-culture with synovium showed less condensation and VEGF secretion<br />
in early cultivation phases, where – interestingly –a slightly elevated initial<br />
inflammatory environment has been observed. As proof of principle, the<br />
chondro-synovial biochip was then used to screen the effect of TGF-β3-induced<br />
fibrotic remodeling under low serum conditions, which resulted in<br />
a particularly strong condensation reaction of the synovial organoid, while<br />
interleukin as well as matrix metalloprotease levels were comparable to less<br />
fibrotic conditions. Based on these initial results, the effect of TNFα on the<br />
architecture and soluble crosstalk is currently under investigation to learn more<br />
about the molecular contribution of the chondro-synovial axis in arthritis.<br />
Dr. Mario Rothbauer<br />
Author:<br />
Since 2019, Mario Rothbauer<br />
has been a Post-Doc at the<br />
‚Karl Chiari Lab for Orthopedic<br />
Biology‘. In 2015, he received<br />
his doctorate in biotechnology<br />
from the University of Natural<br />
Resources and Life Sciences<br />
Vienna (BOKU). The main focus<br />
of his research is the bioengineering<br />
of human disease<br />
models using organ- and labon-a-chip<br />
technologies.<br />
References:<br />
1<br />
Herbert Stiller Preis 2019 https://www.aerzte-gegen-tierversuche.de/de/news/aktuellenews/3005-herbert-stiller-foerderpreis-fuer-tierversuchsfreie-forschung-vergeben.<br />
2<br />
Eilenberger, C.; Rothbauer, M.; Selinger, F.; Gerhartl, A.; Jordan, C.; Harasek, M.; Schädl, B.; Grillari, J.;<br />
Weghuber, J.; Neuhaus, W.; Küpcü, S.; Ertl, P. A Microfluidic Multisize Spheroid Array for Multiparametric<br />
Screening of Anticancer Drugs and Blood–Brain Barrier Transport Properties. Adv. Sci. 2021,<br />
n/a (n/a), 2004856. https://doi.org/https://doi.org/10.1002/advs.<strong>2020</strong>04856.<br />
3<br />
Schuller, P.; Rothbauer, M.; Kratz, S. R. A.; Höll, G.; Taus, P.; Schinnerl, M.; Genser, J.; Bastus, N.;<br />
Moriones, O. H.; Puntes, V.; Huppertz, B.; Siwetz, M.; Wanzenböck, H.; Ertl, P. A Lab-on-a-Chip<br />
System with an Embedded Porous Membrane-Based Impedance Biosensor Array for Nanoparticle<br />
Risk Assessment on Placental Bewo Trophoblast Cells. Sensors Actuators B Chem. <strong>2020</strong>, 127946.<br />
https://doi.org/https://doi.org/10.1016/j.snb.<strong>2020</strong>.127946.<br />
4<br />
Rothbauer, M.; Charwat, V.; Bachmann, B.; Sticker, D.; Novak, R.; Wanzenböck, H.; Mathies, R. A.; Ertl, P.<br />
Monitoring Transient Cell-to-Cell Interactions in a Multi-Layered and Multi-Functional Allergy-on-a-<br />
Chip System. Lab Chip 2019, 19 (11), 1916–1921. https://doi.org/10.1039/c9lc00108e.<br />
5<br />
Rothbauer, M.; Byrne, R. A.; Schobesberger, S.; Calvo, I. O.; Fischer, A.; Reihs, E. I.; Spitz, S.; Bachmann,<br />
B.; Sevelda, F.; Holinka, J.; Holnthoner, W.; Redl, H.; Tögel, S.; Windhager, R.; Kiener, H. P.; Ertl, P.<br />
Establishment of a Human Three-Dimensional Chip-Based Chondro-Synovial Co-Culture Joint<br />
Model for Reciprocal Cross-Talk Studies in Arthritis Research. bioRxiv 2021, 2021.02.19.431936.<br />
https://doi.org/10.1101/2021.02.19.431936.
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Biological Regeneration<br />
in Early Osteoarthritis<br />
In <strong>2020</strong>, researchers of the Department of Orthopedics and Trauma<br />
Surgery published an article entitled „Biological Regeneration of<br />
Articular Cartilage in an Early Stage of Compartmentalized Osteoarthritis:<br />
12-Month Results“ in the American Journal of Sports<br />
Medicine 1 . The paper was the result from fruitful interdisciplinary<br />
cooperation between clinical scientists, orthopedic surgeons, and<br />
basic researchers. For her work, Dr. Martina Hauser-Schinhan was<br />
awarded the Research Award of the „Österreichische Gesellschaft<br />
für Orthopädie und Orthopädische Chirurgie (ÖGO)“ which honors<br />
outstanding scientific contributions that have an impact on the<br />
entire field of orthopedics.<br />
Background<br />
Osteoarthritis is the most common joint disease in the western world. It is<br />
characterized by degenerative chondropathy, subchondral bone sclerosis,<br />
and the presence of osteophytes. In contrast to focal cartilage defects,<br />
osteoarthritis affects the entire joint. To date, the curative treatment of<br />
osteoarthritis is limited to joint replacement surgery. However, this entails<br />
certain surgical risks and limited implant survival, especially in young sportive<br />
patients. The demands regarding regeneration, which are also made more<br />
and more by older patients due to their increased activity, can often not be<br />
met with artificial joints. In localized cartilage defects without osteoarthritis,<br />
cartilage regeneration using different methods depending on the size of the<br />
defect has already become clinical reality 2 .<br />
Study:<br />
Schinhan M, Toegel S, Weinmann<br />
D, Schneider E, Chiari C,<br />
Gruber M, Nehrer S, Windhager<br />
R. Biological Regeneration of<br />
Articular Cartilage in an Early<br />
Stage of Compartmentalized<br />
Osteoarthritis: 12-Month<br />
Results. Am J Sports Med.<br />
<strong>2020</strong> May;48(6):1338–1346.<br />
The autologous chondrocyte transplantation technique was already described<br />
in 1994 by Brittberg et al. 3 . A further development of this approach is<br />
MACT (matrix-assisted autologous chondrocyte transplantation), in which<br />
chondrocytes are inserted into the cartilage defect on a carrier matrix. Due<br />
to the poor results of this technique in arthritic joint conditions 4 , the patient<br />
group with early osteoarthritis can only be treated with symptomatic therapy.<br />
Methods<br />
To find a solution for this group of patients, two large animal studies with<br />
follow-up periods of 4 and 12 months, respectively, were carried out as<br />
part of an EU-funded project 1,5 . In total, 48 Austrian mountain sheep were<br />
operated twice. First, unicompartmental osteoarthritis was induced in the<br />
stable joint by removing a standardized cartilage cylinder (7 mm defect with<br />
a loading time of 12 weeks). The removed cartilage was used for the isolation<br />
and cultivation of autologous chondrocytes. In a second procedure, the sheep
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47<br />
Figure 1. (A) Intraoperative picture of the medial<br />
femoral condyle after spongialization. The size of<br />
the defect was standardized to remove the most<br />
degenerated cartilage areas. Macroscopic image<br />
of the (B) MACT group at the 12-month follow-up.<br />
were separated into three different treatment groups (SPONGIO, MATRIX,<br />
MACT) and one control group in which the cartilage defect and the surrounding<br />
tissue were not treated.<br />
In the sheep of the SPONGIO group, the cartilage of the load-bearing zone of<br />
the medial femoral condyle was removed with a standardized oval punch and<br />
a curette. The bone was then removed to a depth of 2.5 mm using a burr with<br />
a spherical and a cylindrical attachment. This technique is called „spongialization“<br />
6 . Bleeding was stopped with a thin layer of fibrin glue (Figure 1A).<br />
„To date, the curative treatment of<br />
osteoarthritis is limited to joint<br />
replacement surgery. However, this<br />
entails certain surgical risks and<br />
limited implant survival, especially<br />
in young sportive patients.“<br />
Stefan Toegel<br />
The animals in the MATRIX group received the same treatment as those in the<br />
SPONGIO group, with the difference that a hyaluronic acid matrix was applied<br />
on top of the fibrin layer. In the MACT group, the procedure was similar to that<br />
in the MATRIX group. The difference was that the hyaluronic acid matrix was<br />
colonized with autologous cultured chondrocytes (1 x 10 6 cells per cm 2 ) before<br />
implantation. The macroscopic evaluation of the cartilage regeneration was<br />
carried out using the Brittberg Score, whereas the histological evaluation was<br />
performed using the Mankin Score and the O’Driscoll Score.<br />
Results<br />
Results of the control group showed a gradual, significant deterioration of<br />
osteoarthritis over 4 and 12 months. There was no regeneration in the defect<br />
area, and the adjacent cartilage showed increasing degeneration both<br />
macroscopically and histologically. In all treatment groups, the regenerated<br />
cartilage showed a zonal structure. After 4 months, the MACT group yielded<br />
significantly better results than the other two regeneration groups (MATRIX,<br />
SPONGIO) regarding macroscopic and histological parameters. The SPONGIO<br />
group showed good chondrocyte quality after 4 months, but the cartilage<br />
surface was very uneven. The MATRIX group was dominated by the formation<br />
of regenerated tissue, which did not correspond to hyaline cartilage.<br />
In the course of 4 to 12 months, an improvement in all regeneration groups<br />
was detected. In 4 out of 6 sheep of the MACT group, the regenerate filled<br />
the full height of the 2.5 mm deep and 20x10 mm large defect (Figure 1B).<br />
Excessive regeneration above the normal cartilage cell height was not<br />
present in any of the animals. Safranin O staining of the regenerated mate-
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48<br />
Figure 2. Histological sections of regenerated<br />
articular cartilage in the MACT group stained with<br />
safranin O at the 12-month follow-up. Shown is<br />
the center of the regenerated area at 2 magnifications.<br />
Blood vessels crossing the tidemark<br />
are marked with arrows, and the chondrocyte<br />
arrangement in the deep zone of cartilage is<br />
presented at a higher magnification. Scale bar:<br />
200 µm (100x), 50 µm (400x).<br />
rial revealed only a slight reduction in staining in MACT and SPONGIO groups<br />
compared to healthy cartilage tissue. In contrast, the MATRIX group showed<br />
strongly reduced staining. The tidemark was broken by blood vessels in all regeneration<br />
groups. Chondrocytes arranged in columns in the central defect area<br />
of the MACT group, suggesting the formation of hyaline cartilage (Figure 2).<br />
In summary, the analysis of the histological evaluation of the 12-month<br />
results showed significant superiority of the MACT and SPONGIO groups<br />
compared to the MATRIX group.<br />
Conclusion<br />
Early OA was treated successfully in a large animal model, with the MACT group<br />
showing the best regeneration after 4 months, persisting until 12 months with<br />
even further improvement during this time. The good results of the SPONGIO<br />
group can be attributed to the use of fibrin glue which was used to stop the<br />
bleeding and standardize the model, and which might have also acted as a<br />
matrix for cells. The poor results of the MATRIX group could be explained by the<br />
sealing of the cancellous bone with flat fibrin glue preventing the migration of<br />
stem cells from the bone into the matrix, suggesting implications for clinical<br />
application in terms of matrix fixation. Further studies are needed to assess<br />
whether these results can be directly transferred to the human knee joint.<br />
Assoz. Prof. Priv.-Doz. Mag. Dr. Stefan Toegel<br />
References:<br />
Author:<br />
Stefan Toegel is head of the<br />
„Karl Chiari Lab for Orthopaedic<br />
Biology“. In 2015, he became an<br />
Associate Professor at the Medical<br />
University of Vienna and<br />
obtained his habilitation in Cell<br />
Biology in 2018. The main focus<br />
of his research is on the pathomechanisms<br />
of osteoarthritis.<br />
1 <br />
Schinhan M, Toegel S, Weinmann D, et al. Biological regeneration of articular cartilage in an early<br />
stage of compartmentalized osteoarthritis: 12-month results. Am J Sports Med. <strong>2020</strong>;48:1338–46.<br />
2 <br />
Aldrian S, Zak L, Wondrasch B, et al. Clinical and radiological long- term outcomes after matrixinduced<br />
autologous chondrocyte transplantation: a prospective follow-up at a minimum of 10 years.<br />
Am J Sports Med. 2014;42:2680–2688.<br />
3 <br />
Brittberg M, Lindahl A, Nilsson A, et al. Treatment of deep cartilage defects in the knee with autologous<br />
chondrocyte transplantation. N Engl J Med. 1994;331:889–895.<br />
4 <br />
Brix MO, Stelzeneder D, Chiari C, et al. Treatment of full-thickness chondral defects with Hyalograft<br />
C in the knee: long-term results. Am J Sports Med. 2014;42:1426–1432.<br />
5 <br />
Schinhan M, Gruber M, Dorotka R, et al. Matrix-associated autologous chondrocyte transplantation<br />
in a compartmentalized early stage of osteoarthritis. Osteoarthr Cartilage. 2013;21:217–225.<br />
6 <br />
Ficat RP, Ficat C, Gedeon P, et al. Spongialization: a new treatment for diseased patellae.<br />
Clin Orthop Relat Res. 1979;144: 74–83.
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49<br />
Total Hip Arthroplasties<br />
after Chiari Pelvic Osteotomy<br />
Total hip arthroplasty (THA) in untreated developmental dysplasia<br />
of the hip (DDH) poses a challenge on the surgeon, as unusual<br />
anatomy, deficient acetabular bone stock, proximal femoral<br />
malrotation, leg length differences, and soft tissue contractions<br />
need to be considered 1-3 . Studies report higher complication rates<br />
and worse outcomes for THA in patients with DDH compared to<br />
primary osteoarthritis 1, 4 . Controversy exists whether prior pelvic<br />
osteotomies have negative effects on subsequent THA.<br />
Many authors have noted that a successful CPO would facilitate the initial<br />
situation for THA by improving the coverage of the femoral head, thus increasing<br />
the bone stock for implantation and fixation of the acetabular component,<br />
and therefore possibly leading to better clinical results 5-8 . The aim of our study<br />
was to carry out a retrospective analysis focusing on the long-term results<br />
of THA after prior CPO and to look at the rate of and reasons for early THA<br />
failures and revision surgery.<br />
Materials and Methods<br />
We screened patient charts and X-rays from all patients who had undergone<br />
a CPO at our department between 1953 and 1986 and invited them to attend<br />
a follow-up examination. Of this consecutive series of 1536 CPOs, follow-up<br />
was completed in 405 patients, with 504 CPOs after a mean time of 36 years<br />
(±8; range, 22-54 years) 9 . The mean age of all patients at CPO was 25.3 years<br />
(±12.8; range, 1.8-55.3). All patients who had already undergone THA (301 hips;<br />
60%) at the time of follow-up examination were included in the study cohort.<br />
Study:<br />
Schneider E, Stamm T, Schinhan<br />
M, Peloschek P, Windhager R,<br />
Chiari C. Total Hip Arthroplasty<br />
after Previous Chiari Pelvic<br />
Osteotomy-A Retrospective<br />
Study of 301 Dysplastic Hips.<br />
J Arthroplasty. <strong>2020</strong><br />
Dec;35(12):3638–3643.<br />
Study Population and Patient Assessment<br />
The study cohort comprised 221 female (90%) and 24 male (10%) patients.<br />
The mean time between CPO and THA was 24.5 years (±10; range,<br />
1 months-45.9). Revision operations were conducted on average 9.6 years<br />
(±6.1; range 4 months-25.4 years) after conversion THA. Patient’s average<br />
age at the time of revision was 57.9 years (±10; range, 33.2-78.5).<br />
Follow up was performed after an average time of 12.7 years (±7.4; range,<br />
2 weeks-36.9 years) after THA.<br />
66 patients (81 THAs) followed our invitation and underwent clinical examination,<br />
179 patients (220 hips) were interviewed on the phone. Information<br />
on former medical history, date and side of THA, peri- and postoperative<br />
complications, and revision surgery was collected and the Harris Hip Score<br />
(HHS) concerning pain and function was completed.
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50<br />
A<br />
B<br />
C<br />
Figure 1: Case: male patient borne 1939;<br />
An arthrodesis of his right hip was performed<br />
in 1956 after seven years of conservative<br />
treatment for tuberculosis. In 1979 his left hip<br />
was treated with a Chiari PO for dysplasia with<br />
subluxation. In 1992 the patient underwent THA<br />
on the right side and in 1995 (16 years after PO)<br />
on the left side. Latest FU 2017 (22 years after<br />
THA): the patient’s satisfaction was good, the<br />
Trendelenburg sign was positive, he showed<br />
almost no pain and good mobility.<br />
(A) Preoperative X-ray<br />
(B) Post PO left (1979)<br />
(C) 1 Year post -PO left (1980)<br />
(D-E) implantation of THA 1995, X-ray<br />
22 years post THA (2017)<br />
D<br />
E<br />
Radiological Evaluation and Results<br />
60 patients with 74 hips attended the radiological follow up. We compiled the<br />
inclination angle of the acetabular cup, signs of radiolucency, ossifications,<br />
and the presence of acetabular roof plasty. The overall survival (OS) of the THA<br />
after 8-, 10-, 20- and 25 years was 95%, 93%, 76% and 68%, respectively.<br />
„This retrospective study supports the<br />
hypothesis that prior CPO does not compromise<br />
the prerequisites for successful<br />
conversion THA at a later stage.“<br />
Eleonora Schneider<br />
12% (N=37) of all patients underwent a revision THA procedure after an<br />
average time period of 9.6 years (±6.1; range 4 months-25.4). Four patients<br />
(11% of all revisions) underwent revision surgery within two years after THA.<br />
Two patients had the acetabular component revised (50% of the early revision),<br />
one for aseptic loosening after four months, the other for breakage of the acetabular<br />
component after nine months. One patient had a total revision (25%)<br />
for aseptic loosening and shaft fracture after 23.9 months. One patient underwent<br />
revision surgery at another hospital due to unknown reasons (25%)<br />
after twelve months. Of the remaining 33 patients one third needed revision<br />
of the acetabular component (N = 11, 33%). Reasons for acetabular revision<br />
surgery were twice aseptic loosening, one dislocation of the component and<br />
once wear. In seven cases the patient could not specify the reason. Total revisions<br />
were performed in nine patients (27%; 3 aseptic loosening, 1 infection,<br />
1 luxation, 3 unknown). Seven hips (21%) had the head and inlay revised, the<br />
reason being excessive wear in five of them, and no identifiable reason in the<br />
other two. Three femoral stems had to be revised for unknown reasons (9%).<br />
In one patient a Girdlestone surgery was performed due to infection (3%). Two<br />
patients reported on a revision surgery on the phone but could not give any<br />
valid details on reason or extent of the performed procedures (6%).<br />
Neither patient’s age at the time of CPO (p= 0.199) nor the age at the time of<br />
THA (p = 0.210) had significant influence on the incidence of revision surgery.<br />
Out of 245 patients (301 hips), 81 were clinically investigated and nine of<br />
them (11%) reported about early complications: two intraoperative femoral<br />
fractures, two postoperative deep venous thrombosis, and five postoperative
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51<br />
nerve lesions (1 N. femoralis, 1 N. peronaeus, 3 unspecified). The average<br />
acetabular component inclination angle was 42° (±7.3; range 21°-63°).<br />
Twelve hips (16%) showed an acetabular roof plasty, its presence had no<br />
significant influence on the probability of revision surgery (p = 0.3368). Four<br />
hips (5%) showed radiolucent lines around the acetabular component, but<br />
none of them had revision surgery so far. In eight hips (11%) radiolucency<br />
was detected around the stem, two (25%) of them were in the group of patients<br />
who had already undergone revision surgery (one due to loosening of the stem,<br />
the other due to polyethylene wear).<br />
Discussion and Conclusion<br />
We found a revision rate of 12% for THA after CPO at an average follow up of<br />
12.7 years (±7.4; range, 2 weeks-36.9 years). The revision rate of 12% could<br />
be partly owed to the long follow up interval, as complications probably had<br />
time to develop, be detected, and addressed. Secondly, 62% of all conversion<br />
THAs were performed prior to the year 2000 and may have resulted in higher<br />
revision rates as older polyethylene components were used. However, the<br />
revision rate compares to other studies in the literature seems to be at the<br />
lower end.<br />
Regarding the overall survival rate, we found out, that conversion THAs after<br />
CPO (10-year OS 93%) would show a similar 10-year survival rate to primary<br />
THA due to osteoarthritis, as reported in the Swedish (95,8%), US (95.2%)<br />
and Australian (93.5%) registries. We could also show that our 10- and 20-<br />
year survival rates (93% and 76%, respectively) were superior to the ones of<br />
patients younger than 35 years with primary THA for osteoarthritis (87% and<br />
61%, respectively) or untreated DDH (87% and 55%) 10,11 . This retrospective<br />
study supports the hypothesis that prior CPO does not compromise the<br />
prerequisites for successful conversion THA at a later stage.<br />
References:<br />
1<br />
Garvin, K.L., et al., Long-term results of total hip arthroplasty in congenital dislocation and<br />
dysplasia of the hip. A follow-up note. J Bone Joint Surg Am, 1991. 73(9): p. 1348–54.<br />
2<br />
Gill, T.J., J.B. Sledge, and M.E. Muller, Total hip arthroplasty with use of an acetabular reinforcement<br />
ring in patients who have congenital dysplasia of the hip. Results at five to fifteen years.<br />
J Bone Joint Surg Am, 1998. 80(7): p. 969–79.<br />
3<br />
Numair, J., et al., Total hip arthroplasty for congenital dysplasia or dislocation of the hip.<br />
Survivorship analysis and long-term results. J Bone Joint Surg Am, 1997. 79(9): p. 1352–60.<br />
4<br />
Crowe, J.F., V.J. Mani, and C.S. Ranawat, Total hip replacement in congenital dislocation<br />
and dysplasia of the hip. J Bone Joint Surg Am, 1979. 61(1): p. 15–23.<br />
Dr. in Eleonora Schneider<br />
5<br />
Hoffman, D.V., E.H. Simmons, and T.W. Barrington, The results of the Chiari osteotomy.<br />
Clin Orthop Relat Res, 1974(98): p. 162–70.<br />
6<br />
Hogh, J. and M.F. Macnicol, The Chiari pelvic osteotomy. A long-term review of clinical and<br />
Author:<br />
Eleonora Schneider is currently<br />
completing her residency at the<br />
Department of Orthopaedics and<br />
Trauma Surgery at the Medical<br />
University of Vienna. The main<br />
focus of her research lies on<br />
joint preserving techniques (hip<br />
and knee).<br />
radiographic results. J Bone Joint Surg Br, 1987. 69(3): p. 365–73.<br />
7<br />
Lack, W., et al., Chiari pelvic osteotomy for osteoarthritis secondary to hip dysplasia. Indications<br />
and long-term results. J Bone Joint Surg Br, 1991. 73(2): p. 229–34.<br />
8<br />
Ohashi, H., K. Hirohashi, and Y. Yamano, Factors influencing the outcome of Chiari pelvic osteotomy:<br />
a long-term follow-up. J Bone Joint Surg Br, 2000. 82(4): p. 517–25.<br />
9<br />
Chiari C, K.R., Windhager R, , Chiari and Salvage Osteotomy for the Treatment of Symptomatic<br />
Acetabular Dysplasia, in The Adult Hip: Hip Preservation Surgery, B.P. Clohisy JC, Della Valle CJ,<br />
Callaghan JJ, Rosenberg AG, Rubash HE, Editor. 2015, Wolters Kluwer: Philadelphia, PA.<br />
10<br />
Swarup, I., et al., Implant Survival and Patient-Reported Outcomes After Total Hip Arthroplasty in<br />
Young Patients. J Arthroplasty, 2018. 33(9): p. 2893–2898.<br />
11<br />
Swarup, I., et al., Implant survival and patient-reported outcomes after total hip arthroplasty<br />
in young patients with developmental dysplasia of the hip. Hip Int, 2016. 26(4): p. 367–73.
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52<br />
The MOCART 2.0 Knee Score:<br />
Morphological MRI for the<br />
Assessment of Cartilage Repair<br />
„Orthopedic surgeons and radiologists<br />
with a special focus on musculoskeletal<br />
radiology and cartilage repair joint<br />
forces to develop a new and updated<br />
version of the original MOCART score,<br />
which would incorporate the developments<br />
in cartilage repair surgery and<br />
MR imaging alike. This culminated in<br />
the publication of the MOCART 2.0 knee<br />
score and atlas.“<br />
Markus Schreiner<br />
Symptomatic focal cartilage defects in young and active patients<br />
pose a significant challenge to the orthopedic surgeon. Left untreated,<br />
focal cartilage defects may increase in size and ultimately<br />
progress to OA. With an increasing number of different surgical<br />
techniques and scaffolds having become available, the comparison<br />
of clinical outcome between these techniques becomes<br />
increasingly important.<br />
While clinical scores provide information on the overall joint-health and<br />
patient satisfaction, morphological and quantitative MRI may provide<br />
additional information on the status of the repair tissue. The qualitative and<br />
quantitative assessment of cartilage repair tissue has been the focus of the<br />
interdisciplinary research group between the Department for Orthopedics<br />
and Trauma surgery and the High-Field MR Center of the Medical University<br />
of Vienna for some time and lead to the introduction of the MOCART (Magnetic<br />
Resonance Observation of Cartilage Repair Tissue) score.<br />
Study:<br />
Schreiner MM, Raudner M,<br />
Marlovits S, Bohndorf K,<br />
Weber M, Zalaudek M, Röhrich<br />
S, Szomolanyi P, Filardo G,<br />
Windhager R, Trattnig S.<br />
The MOCART (Magnetic Resonance<br />
Observation of Cartilage<br />
Repair Tissue) 2.0 Knee Score<br />
and Atlas. Cartilage. 2019 Aug<br />
17:1947603519865308. doi:<br />
10.1177/1947603519865308.<br />
[Epub ahead of print]<br />
However, since the introduction of the MOCART 2.0 knee score, MRI hardware<br />
as well as MR sequences evolved. Similarly, surgical cartilage repair<br />
techniques were refined, and the MOCART score did not reflect these new<br />
developments. In addition, continuous use of the score for more than a<br />
decade exposed some weaknesses of the scoring system. Hence, orthopedic<br />
surgeons and radiologists with a special focus on musculoskeletal radiology<br />
and cartilage repair joint forces to develop a new and updated version of the<br />
original MOCART score, which would incorporate the developments in cartilage<br />
repair surgery and MR imaging alike. This culminated in the publication<br />
of the MOCART 2.0 knee score and atlas.<br />
Main improvements of the score<br />
The main improvements of the score include the elimination of the assessment<br />
of adhesions, the variable „subchondral lamina“, and the variable<br />
„synovitis“. Regarding the variables that were adapted, the variable „volume<br />
of cartilage defect filling“ now allows for a more precise evaluation of defect<br />
filling in 25% increments. Furthermore, hypertrophic filling of up to 150%<br />
being is now being scored with the same scoring as complete repair, as it has<br />
been previously shown that minor hypertrophy has no detrimental effects<br />
on clinical symptoms or long-term outcome. The variable „integration“<br />
was changed in a way that it now only assesses integration to neighboring
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53<br />
1 Volume fill of cartilage defect Scoring<br />
1 Complete filling OR minor hypertrophv: 100 to 150 % filling of total defect volume 20<br />
2 Major hypertrophy ≥ 150 % (1_2a) OR 75 - 99 % filling of total defect volume (1_2b) 15<br />
3 50 - 74% filling of total defect volume 10<br />
4 25 -49% filling of total defect volume 5<br />
5 < 25% filling of total defect volume (1_5a) OR complete delamination in situ (1_5b) 0<br />
2 Integration into adjacent cartilage<br />
1 Complete integration 15<br />
2 Split-like defect at repair tissue and native cartilage interface ≤ 2mm 10<br />
3 Defect at repair tissue and native cartilage interface > 2mm, but < 50 % of repair tissue length 5<br />
4 Defect at repair tissue and native cartilage interface ≥ 50 % of repair tissue length 0<br />
3 Surface of the repair tissue<br />
1 Surface intact 10<br />
2 Surface irregular < 50 % of repair tissue diameter 5<br />
3 Surface irregular ≥ 50 % of repair tissue diameter 0<br />
4 Structure of the repair tissue<br />
1 Homogeneous 10<br />
2 lnhomogeneous 0<br />
5 Signal intensity of the repair tissue<br />
1 Normal 15<br />
2 Minor abnormal - minor hyperintense (5_2a) OR minor hypointense (5_2b) 10<br />
3 Severely abnormal - almost fluid like (5_3a) OR close to subchondral plate signal (5_3b) 0<br />
6 Bony defect or bony overgrowth<br />
1 No bony defect or bony overgrowth 10<br />
2 Bony defect: depth < thickness of adjacent cartilage (6_2a) OR overgrowth<br />
< 50 % of adjacent cartilage (6_2b) 5<br />
3 Bony defect: depth ≥ thickness of adjacent cartilage (6_2a) OR overgrowth ≥ 50 %<br />
of adjacent cartilage (6_2b) 0<br />
7 Subchondral changes<br />
1 No major subchondral changes 20<br />
2 Minor edema-like marrow signal – maximum diameter < 50 % of repair tissue diameter 5<br />
3 Severe edema-like marrow signal – maximum diameter ≥ 50 % of repair tissue diameter 10<br />
4 Subchondral cyst ≥ 5mm in longest diameter (7_4a) or osteonecrosis-like signal (7_4b) 0<br />
Figure 1: Scoring sheet of the Magnetic Resonance<br />
Observation of Cartilage Repair Tissue (MOCART)<br />
2.0 knee score.<br />
cartilage and not underlying bone. Surface irregularities are now subdivided<br />
with respect to cartilage repair length rather than depth to reduce overlap<br />
with the variable filling of the repair tissue. The variable „structure of the<br />
repair tissue“ was kept unchanged. The variable „signal intensity of the repair<br />
tissue“ was adapted to better reflect the reality of current imaging protocols<br />
in clinical routine. Whereas it used to be common practice to measure both<br />
a dual T2w TSE and a T1 3D GRE fs sequence at the time of the introduction<br />
of the original MOCART score, nowadays most protocols do not contain both<br />
sequences anymore. Hence, the signal intensity of the repair tissue is now<br />
recommended to be assessed on a single PDw TSE sequence. Both hypointense<br />
and hyperintense signal changes can now be scored in one variable.<br />
To acknowledge the recent focus on subchondral bone, assessment of bony<br />
defects and subchondral bone is more prominently featured in the MOCART<br />
2.0 knee score. The introduction of the variable „bony defect or bony overgrowth“<br />
allows for the scoring of bony defects as well as intrachondral<br />
osteophytes, which are commonly observed after microfracture and were not<br />
accounted for in the original MOCART score. Furthermore, the variable „sub-
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54<br />
Figure 2: Sagittal proton-density-weighted turbo spin-echo image without fat saturation (A) and<br />
coronal proton-density-weighted turbo spin-echo image with fat saturation of a 31-year-old<br />
female patient 29 months after MACI of a grade IV cartilage lesion of the medial femoral condyle<br />
of the right knee with an overall MOCART 2.0 knee score of 80 points.<br />
chondral bone“ was changed to the variable „subchondral changes“ and now<br />
incorporates the assessment of the presence of bone-marrow edema-like<br />
marrow signal, which can be further subdivided into minor and severe, as<br />
well as the presence of subchondral cysts and osteonecrosis like signals.<br />
Dr. Markus Schreiner<br />
Author:<br />
Markus Schreiner has been a<br />
resident at the Department of<br />
Orthopedics and Trauma Surgery<br />
at the Medical University<br />
of Vienna since 2016 and is a<br />
member of the biomedical MRimaging<br />
Cluster of orthopedic<br />
disorders. Since 2019 he has<br />
coordinated the scientific collaborations<br />
between the Orthopedic<br />
department and the High<br />
Field MR Centre (Prof. Siegfried<br />
Trattnig) at the Medical University<br />
of Vienna, together with<br />
Sebastian Apprich M.D.<br />
Within the biomedical MRimaging<br />
cluster, his research<br />
focuses on the development<br />
and implementation of MR<br />
imaging techniques used for<br />
qualitative and quantitative assessment<br />
of cartilage, tendons,<br />
and intervertebral discs as well<br />
as clinical projects on cartilage<br />
repair surgery.<br />
Evaluation of the MOCART 2.0<br />
The new MOCART 2.0 knee score was then used by two senior radiologists<br />
and two junior radiologists with little or no previous exposure to musculoskeletal<br />
radiology to assess the MRI examination of 24 patients after MACT. All<br />
MRI imaging studies were performed on 3T MR systems with dedicated knee<br />
coils. The average age of the included 24 patients (11 female, 13 male) was<br />
34.8 ± 10.9 years. The median postoperative follow-up interval was 2.3 years.<br />
Median lesion size was 3.8cm2, ranging from 0.9. to 12cm.<br />
When designing the MOCART 2.0 knee score, special emphasis was put on<br />
reproducibility. To ensure that scorings would be consistent between readers<br />
and therefore studies, an atlas was developed alongside the score, which<br />
contains example images for every possible scoring of the MOCART 2.0. knee<br />
score. To assess whether use of this additional resource would provide any<br />
additional value, the inexperienced readers assessed all imaging studies for<br />
a second time after a four-week interval, with the difference that for the second<br />
reading, access to the atlas of the MOCART 2.0. knee score was granted.<br />
The expert readers demonstrated almost perfect overall intrarater<br />
(ICC=0.88, p
TOP-Studien<br />
The Genetic Landscape<br />
of Axonal Neuropathies:<br />
Focus on MME<br />
55<br />
Study:<br />
Senderek J, Lassuthova P,<br />
Kabzińska D, Abreu L, Baets J,<br />
Beetz C, Braathen GJ, Brenner<br />
D, Dalton J, Dankwa L, Deconinck<br />
T, De Jonghe P, Dräger B,<br />
Eggermann K, Ellis M, Fischer<br />
C, Stojkovic T, Herrmann DN,<br />
Horvath R, Høyer H, Iglseder<br />
S, Kennerson M, Kinslechner<br />
K, Kohler JN, Kurth I, Laing<br />
NG, Lamont PJ, Wolfgang N<br />
L, Ludolph A, Marques W Jr,<br />
Nicholson G, Ong R, Petri<br />
S, Ravenscroft G, Rebelo A,<br />
Ricci G, Rudnik-Schöneborn S,<br />
Schirmacher A, Schlotter-<br />
Weigel B, Schoels L, Schüle R,<br />
Synofzik M, Francou B, Strom<br />
TM, Wagner J, Walk D, Wanschitz<br />
J, Weinmann D, Weishaupt<br />
J, Wiessner M, Windhager<br />
R, Young P, Züchner S,<br />
Toegel S, Seeman P, Kochański<br />
A, Auer-Grumbach M. The<br />
genetic landscape of axonal<br />
neuropathies in the middleaged<br />
and elderly: Focus on<br />
MME. Neurology. <strong>2020</strong> Dec<br />
15;95(24):e3163-e3179<br />
The genetic diversity of Charcot-Marie-Tooth (CMT) syndrome,<br />
a hereditary motor-sensory neuropathy, is still not fully explored.<br />
CMT consists of several subtypes, however, CMT1 (demyelinating<br />
form) and CMT2 (axonal form) are the most common types 1 .<br />
The disease onset of CMT usually starts in childhood, but lateonset<br />
forms have been described 2 . For the latter, rare variants<br />
in MME, encoding the metalloprotease neprilysin, have been<br />
published earlier by our group 3 . Here, this international and interdisciplinary<br />
study reveals new gene variants of CMT2 for midelderly<br />
and individuals older than 65 years, leading to late-onset<br />
manifestations.<br />
To investigate unexplained axonal neuropathies and disease onset in<br />
patients older than 35 years, 230 individuals were included into this study.<br />
From 2012 until 2016 clinical and electrophysiological screenings were<br />
conducted and genetic analyses were performed. For the latter, DNA was<br />
isolated from patient’s blood and samples underwent either whole-exome<br />
sequencing (WES, n = 126) or MME single-gene sequencing (n = 104).<br />
Furthermore, the concentration of neprilysin was measured by ELISA in<br />
patients’ blood.<br />
Genetic Causes Identified by WES<br />
126 DNA samples were screened by WES and for 23 samples rare nonsynonymous<br />
likely pathogenic variants were identified, related to CMT2<br />
or resembling the CMT2 phenotype. The most frequently involved gene<br />
was MME (n = 8), followed by LRSAM1 (n = 3), MPZ (n = 2), TTR (n = 2)<br />
and HMBS, VCP, WARS, AARS, DHTKD1, GARS, HARS and HSPB8 (n = 1,<br />
respectively). Concerning the MME gene, three patients carried rare<br />
biallelic variants consistent with autosomal recessive inheritance, while<br />
five patients carried single heterozygous loss-of-function (frameshift,<br />
nonsense or splice) variants.<br />
Targeted sequencing of the MME gene<br />
104 DNA samples were screened independently for MME variants and<br />
revealed private or rare variants in 14 patients. One individual was consistent<br />
with autosomal recessive inheritance, four patients carried single
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56<br />
Late-onset gnomAD all gnomAD European HZN GENESIS<br />
neuropathies exomes exomes exomes exomes<br />
Number of 230 123,136 55,860 11,225 3,793<br />
samples (alleles) (460) (246,272) (111,720) (22,500) (7,586)<br />
Loss-of-function 9 (0.01957) 172 (0.0007024) 91 (0.0008187) 15 (0.0000667) 3 (0.0004653)<br />
variants * P = 9.35E-11 P = 4.33E-10 P = 4.82E-10 P = 1.14E-9<br />
Rare missense 14 (0.03043) 1,562 (0.006361) 592 (0.005319) 206 (0.009156) 50 (0.006591)<br />
variants # P = 2.3E-6 P = 3.22E-7 P = 0.00015 P = 0.00001<br />
Rare, serious 13 (0.02826) 926 (0.003771) 414 (0.003720) 131 (0.005822) NA<br />
missense variants † P = 4.78E-9 P = 3.70E-8 P = 6.89E-6<br />
p.Pro15 6Leufs * 14 2 (0.004348) 62 (0.0002525) 33 (0.0002965) 6 (0.0002667) 2 (0.0002036)<br />
P = 0.00652 P = 0.0092 P = 0.01 P = 0.018<br />
p.Tyr347Cys 8 (0.01739) 128 (0.0005202) 117 (0.001049) 41 (0.001822) 10 (0.001318)<br />
P = 2.64E-10 P = 5.88E-8 P = 5.36E-6 P = 2.83E-60<br />
p.Met8Val 26 (0.05652) 4,041 (0.01641) 2,719 (0.02435) 544 (0.02418) NA<br />
P = 8.76E-8 P = 0.0001 P = 0.00025<br />
p.Val345lle 4 (0.008696) 463 (0.001882) 354 (0.003174) 67 (0.002978) NA<br />
P=0.012 P = 0.061 P = 0.054<br />
p.Gly225Ala 0 (0) 393 (0.001635) 230 (0.002126) 78 (0.003467) NA<br />
P = 0.99 P = 0.99 P = 0.99<br />
Table 1: Frequencies of MME variants in cases and control.<br />
Figure 1: Manifestations of MME variants ; adapted from 4<br />
(A) Disease severity of cases with autosomal recessive and assumed autosomal dominant inherited MME variants are<br />
shown as proportional distribution (Scores: mild = 1, very severe = 4).<br />
(B) Boxplots comparing neprilysin levels in EDTA plasma obtained from healthy controls (n = 22), late-onset neuropathy<br />
patients without MME variants (n = 34), serious MME variants (n = 15), and the p.Met8Val low-frequency polymorphism<br />
(n = 9).
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57<br />
rare heterozygous loss-of-function variants, and nine patients carried rare<br />
heterozygous missense variants.<br />
„For individuals older than 65 years we<br />
observed that MME variants may act as<br />
completely penetrant recessive alleles<br />
but also lead to dominantly inherited<br />
susceptibility to axonal neuropathies.“<br />
Katharina Pichler<br />
In Table 1 frequencies of MME variants of 230 individuals (cases and controls)<br />
with late-onset neuropathies were compared to all exomes of gnomAD,<br />
European descent exomes of gnomAD, the exomes of Helmholtz Zentrum<br />
München or exomes of GENESIS. The comparison to control datasets<br />
revealed that, for instance, heterozygous MME loss-of-function variants<br />
showed a statistically significant enrichment in our screening cohort.<br />
Clinical manifestations of MME variants<br />
Although the disease manifested with advanced age, it showed a progressive<br />
and severe behaviour. Patients complained of neuropathic pain, with muscle<br />
wasting and weakness with sensory deficits in the lower legs. CMAP amplitudes<br />
were usually below the normal range (
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58<br />
Distal Femur Replacement –<br />
Differences between Oncologic<br />
and Non-Oncologic Conditions<br />
[…] this study is of vital importance since<br />
it is the first one to show the differences<br />
between patients with and without<br />
oncologic conditions undergoing DFR.<br />
Cementation might be a better fixation<br />
method for patients with oncologic<br />
condition […]<br />
Kevin Staats<br />
Study:<br />
Staats K, Vertesich K, Sigmund<br />
IK, Sosa B, Kaider A, Funovics<br />
PT, Windhager R. Does a<br />
Competing Risk Analysis Show<br />
Differences in the Cumulative<br />
Incidence of Revision.<br />
Clin Orthop Relat Res. <strong>2020</strong><br />
May;478(5):1062–1073.<br />
The use of megaprosthetic reconstruction of the extremities<br />
originated from extended bone loss due to wide resection of<br />
bone or soft-tissue tumors. However, due to the growing number<br />
of primary total knee arthroplasty (TKA) and the expanding life<br />
expectancy of patients, information about the outcome of distal<br />
femur replacement (DFR) due to non-oncologic conditions in<br />
revision-TKA (rTKA) is becoming more and more important.<br />
We therefore raised the question, whether differences in patient<br />
population and DFR fixation (cemented or cementless) have an<br />
impact on the outcome after DFR.<br />
In a retrospective cohort study, we analyzed patients undergoing DFR due<br />
to oncologic and non-oncologic indications from 1986 to 2016. We were<br />
able to include 229 patients, in total of which 183 patients underwent DFR<br />
due to oncologic, and 46 patients due to non-oncologic conditions. Patients<br />
undergoing DFR due to oncologic reasons were – as expected – significantly<br />
younger than the cohort with non-oncologic conditions. Cementless fixation<br />
was more often performed in oncologic cases, whereas in the non-oncologic<br />
cohort cementation and cementless fixation were almost equally distributed.<br />
Table 1 displays the basic demographics and differences between<br />
patients with oncologic and non-oncologic reasons undergoing cemented<br />
and cementless DFR. The decision whether patients received cemented or<br />
cementless distal femoral replacements was not based on a strict algorithm.<br />
We strongly believe the indications for cemented or cementless fixation have<br />
not changed dramatically in our institution over time. Usually, cementless<br />
fixation is preferred in young, active patients and in those with primary bone<br />
tumors, whereas cemented fixation is mainly used in older patients with<br />
expected poor bone quality or metastatic bone lesions. However, bone quality<br />
and patient activity level were not assessed for the entire patient cohort.<br />
Regardless of which distal femoral replacement system was used, it always<br />
consisted of a cemented or cementless modular component fitting the metaphyseal<br />
and diaphyseal portion of the distal femur.<br />
Patients and Method<br />
In our study, the 149 patients receiving cementless fixation were younger<br />
(median age 31 years [range 16-55 years]) than the 80 patients with cemented<br />
distal femoral replacement (median age: 54 years [range 27-72 years];
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59<br />
Figure 1: Example of a Distal Femur Replacement<br />
due to a low comminuted periprosthetic distal<br />
femur fracture.<br />
p = 0.001). The endoprosthetic systems used in this study are a fixed-hinge type<br />
of prosthesis (Howmedica Modular Replacement System, Kiel, Germany)<br />
and, beginning in 1999, a modified rotating-hinge version of the fixed-hinge<br />
type (Global Modular Replacement System, Stryker, Kalamazoo, MI, USA)A.<br />
Instead of using a Kaplan-Meier analysis, we performed a competing risk<br />
analysis (Fine-Gray model) for the evaluation of incidence of revision surgery<br />
after DFR. Since patients with oncologic conditions and patients undergoing<br />
DFR due to rTKA have a higher mortality rate than the general population,<br />
we defined “death” as a competing event for revision surgery. Competing risk<br />
analyses have proven to be more accurate than Kaplan-Meier calculations<br />
in patients with higher mortality rates because life expectancy might be too<br />
short for experiencing a revision surgery.<br />
Results<br />
The median follow-up duration in the overall cohort was 85 months (range<br />
0.1-391 months). Thirty-two percent (58 of 183) of oncologic patients and<br />
48% (22 of 46) of non-oncologic patients underwent cemented distal femoral<br />
replacement, representing 35% of the overall cohort. During the observation<br />
period, 30% of the patients (69 of 229) died after DFR, 64 of whom were in<br />
the oncologic cohort. According to the International Society of Limb Salvage’s<br />
classification system, complications leading to revision surgery during the<br />
observation period (1983 to 2016) were either soft-tissue failure (Type 1) in<br />
24 patients (16 with oncologic disease), aseptic loosening (Type 2) in 35 patients<br />
(30 with oncologic disease), structural failure (Type 3) in 19 patients (17 with<br />
oncologic disease), infection (Type 4) in 33 patients (27 with oncologic disease),<br />
or tumor progression (Type 5) in five patients.
TOP-Studien<br />
60<br />
Dr. Kevin Staats<br />
Statistical Analysis<br />
The competing risks analysis revealed cumulative revision incidences of<br />
26% (95% CI, 20.3%-31.9%) at 12 months, 37.9% (95% CI, 31.3%-44.4%)<br />
at 24 months, 52.6% (95% CI, 45.1%-59.5%) at 5 years, and 58.2% (95% CI,<br />
50.1%-65.4%) at 10 years for all patients in this study.<br />
Author:<br />
Kevin Staats started his residency<br />
at the Department of<br />
Orthopedics and Trauma Surgery<br />
at the Medical University<br />
of Vienna in 2016. His research<br />
interests are total joint replacement<br />
and revision arthroplasty<br />
and he is deputy director of the<br />
Arthroplasty Research Cluster.<br />
Dr. Staats was awarded the<br />
Ines Mandl Research Fellowship<br />
and had the opportunity to<br />
expand his clinical and research<br />
focus at the Hospital of Special<br />
Surgery/Weill Cornell University,<br />
New York City. His research on<br />
the antimicrobial effect of electrochemically<br />
modified titanium<br />
surfaces received institutional<br />
funding by CEST Wr. Neustadt<br />
through the FFG-COMET program.<br />
Dr. Staats is currently an<br />
extended board member of the<br />
Austrian Orthopedic Society as<br />
the representative for Austrian<br />
orthopedic residents.<br />
The multivariate analysis adjusted for important variables such as age, sex,<br />
disease (oncologic versus non-oncologic), cementation, and year of surgery<br />
clearly showed that patients with oncologic diagnoses have a lower risk of<br />
undergoing revision surgery than patients with non-oncologic diagnoses (HR<br />
0.44 for oncologic versus non-oncologic; 95% CI, 0.22-0.87; p = 0.02).<br />
Additionally, the multivariate Fine and Gray model yielded an interaction<br />
between the two prognostic factors of oncologic disease and cementation<br />
(p = 0.03), revealing a reduction in the risk of revision with cemented fixation<br />
in patients with oncologic disease (HR 0.53; 95% CI, 0.29-0.98).<br />
According to our results, implant fixation may have a major impact on the<br />
risk of revision surgery in patients with oncologic disease.<br />
Cementation did not have any effect on the cumulative incidence of revision<br />
surgery for any cause in our overall cohort. However, cemented distal femoral<br />
replacements were less frequently revised because of aseptic loosening than<br />
cementless endoprostheses in patients who underwent surgery for oncologic<br />
indications (with an incidence of 6.9% (95% CI, 2.5%-14.3%) at 2 years and<br />
8.6% (95% CI, 3.4%-16.8%) at 5 years, compared with 11.8% (95% CI, 7%-<br />
17.9%) and 19.7% (95% CI, 13.2%-27.1%; p = 0.04), respectively. Due to the<br />
rate of aseptic loosening of cementless implants being almost 12% in the<br />
first two years, we believe that initial implant fixation or osseointegration was<br />
not achieved in patients with oncologic disease.<br />
In conclusion, this study is of vital importance since it is the first one to<br />
show the differences between patients with and without oncologic conditions<br />
undergoing DFR. Cementation might be a better fixation method for<br />
patients with oncologic condition, however further studies are needed to<br />
prove this hypothesis.
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Heraeus Medical GmbH<br />
Philipp-Reis-Str. 8/13<br />
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Switzerland
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62<br />
Biomechanical Evaluation of Intramedullary<br />
Jones Fracture Fixation<br />
Jones fractures or meta-diaphyseal fractures of the proximal fifth<br />
metatarsal (zone II) have a notoriously high rate of nonunion and<br />
delayed union with conservative treatment. Therefore, surgical<br />
fixation using an intramedullary screw is currently recommended<br />
as the primary treatment for active patients, as well as recreational<br />
and professional athletes. Besides early functional mobilization<br />
and a faster return to sports, higher rates of primary fracture<br />
healing have been demonstrated in clinical studies. Nevertheless,<br />
implant choice is a matter of concern since active patients are<br />
prone to failure including nonunion, screw failure, and refracture.<br />
A variety of screw types have been used to treat Jones fractures. Currently,<br />
neither clinical nor biomechanical studies comparing different screws<br />
provide decisive results, so there is no consensus on the ideal screw design<br />
or diameter. Cannulated screws are easy to use and insert but may have a<br />
detrimental biomechanical behavior compared to solid screws. Standard<br />
solid screw insertion can be technically demanding and a prominent screw<br />
head can lead to discomfort and pain at the base of the fifth metatarsal.<br />
A countersinkable or low-profile screw head may reduce this potential<br />
complication, but recent advances in implant design have even developed<br />
fracture-specific screws with combined properties for the treatment of<br />
Jones fractures. To seek clarification in the biomechanical aspects of recent<br />
screw designs regarding the treatment of Jones fractures, this study compares<br />
a solid, fracture-specific screw with a cannulated headless compression<br />
screw in a biomechanical Jones fracture fixation model by simulating initial<br />
postoperative weight-bearing and ultimate loading.<br />
Study:<br />
Willegger M, Benca E, Hirtler L,<br />
Kasparek MF, Bauer G, Zandieh<br />
S, Windhager R, Schuh<br />
R. Evaluation of Two Types of<br />
Intramedullary Jones Fracture<br />
Fixation in a Cyclic and<br />
Ultimate Load Model. J Orthop<br />
Res. <strong>2020</strong> Apr;38(4):911–917.<br />
doi: 10.1002/jor.24530.<br />
Materials and Methods<br />
Ten matched pairs of fresh human foot specimens were used for this biomechanical<br />
study. The specimens were obtained from voluntary donors who<br />
consented to donate their body for research and teaching purposes to the<br />
Center for Anatomy and Cell Biology, Medical University of Vienna during<br />
lifetime. Donor age ranged from 64 to 92 years (mean 78.8 ± 8.7 years). The<br />
specimens were stored at –80°C and thawed at +4°C 48 hours prior to<br />
testing in order to prevent tissue dehydration. After screening for previous<br />
injuries or surgeries at the fifth metatarsal, all specimens proved valid for<br />
inclusion. Bone mineral density (BMD) was assessed prior to biomechanical<br />
testing by use of dual-energy X-ray absorptiometry (DEXA). Scans of the<br />
calcaneus were reported as g/cm 2 . To minimize possible left-right bias, one<br />
foot of each pair was assigned to fracture-specific Jones screw fixation
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63<br />
Figure 1: Biomechanical test setup: The potted fifth<br />
metatarsal specimen was fixed into a machine vice<br />
on an adjustable platform. A metal rod attached to<br />
the loading frame was used for force transmission<br />
in a plantar to dorsal direction. Light-reflecting<br />
hemispherical markers were glued onto the distal<br />
part of the Jones fracture specimen and onto the<br />
pot and rod for kinematic tracking.<br />
„To seek clarification in the biomechanical<br />
aspects of recent screw<br />
designs regarding the treatment of<br />
Jones fractures, this study compares<br />
a solid, fracture-specific screw with<br />
a cannulated headless compression<br />
screw in a biomechanical Jones<br />
fracture fixation model.“<br />
Madeleine Willegger<br />
(Jones Screw; Arthrex Inc., Naples FL, USA) (JFXS group) and the contralateral<br />
foot was assigned to conventional cannulated headless compression<br />
screw fixation (HCS; DePuySynthes, Solothurn, Switzerland) (HCS group),<br />
with equal numbers of right and left feet in each group. The fifth metatarsals<br />
were further dissected and disarticulated from the feet. Jones fractures at<br />
the meta-diaphyseal junction were created using an oscillating saw. Both<br />
screw types were inserted according to the manufacturer’s instructions. The<br />
intramedullary screw had to „fit and fill“ the medullary canal with the threads<br />
across the fracture site. HCS were available in diameters 4.5-mm and 6.5-<br />
mm, and Jones Screws were used in diameters 4.5-mm and 6.0-mm.<br />
An experimental setup was designed to simulate the postoperative in vivo<br />
loading conditions after surgical Jones fracture treatment. The specimens<br />
of the fifth metatarsal were placed with their proximal aspects in Wood’s<br />
metal in specially fabricated custom-made steel cups, which were fixed<br />
in a machine vice. The biomechanical testing was performed with an 858<br />
Mini Bionix ® (MTS ® Systems Corporation, Eden Prairie, MN). (Figure 1) A<br />
metal rod was used for force transmission onto the plantar aspect of the<br />
metatarsal head. An opto-electronic motion capture system (Smart-E; BTS<br />
Bioengineering, Milan, Italy) with four cameras was used during the loading<br />
process to track kinematic changes. Specimens were loaded with a cyclic<br />
load mean of 12 N at 0.5 Hz for 1000 cycles. The number of load cycles<br />
was chosen based on the loading rate for a physiologically normal lower<br />
limb, which is approximately 5000 cycles per day. One thousand cycles per<br />
day were assumed to realistically simulate post-operative loading during
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64<br />
Figure 2: Box plots representing the ultimate<br />
load to failure, in Newton, per screw.<br />
The horizontal line indicates the median,<br />
the box extends from the 25th to the 75th<br />
percentile, and the bars indicate the largest<br />
and smallest observed value.<br />
early active rehabilitation. After completion of cyclic loading, an ultimate<br />
load to failure test was performed. Failure was defined as gross failure due<br />
to fracture, screw bending or breakage, or dorsal angulation of the distal<br />
fragment exceeding 10°. Stiffness (slope), displacement, angulation, and<br />
ultimate loads were compared between both groups. Modes of failure were<br />
classified and analyzed with reference to screw type.<br />
Results<br />
There was no significant difference in stiffness and machine displacement<br />
between fifth metatarsals fixed with the solid Jones Fracture-specific<br />
screw (JFXS group) or the cannulated headless compression screw (HCS<br />
group) at any point during the cyclic loading (stiffness:0.324 ≤ p ≤ 0.986;<br />
displacement: 0.131 ≤ p ≤ 0.635). Interfragmentary angulation increased<br />
from 1st to 1000st cycle in both groups, but not statistically significant.<br />
According to preliminary failure criteria, we found a construct survival of<br />
100% in the JFXS group and 90% in the HCS group during cyclic loading.<br />
Priv.-Doz. in Dr. in Madeleine Willegger, FEBOT<br />
Author:<br />
Madeleine Willegger started<br />
her career at the Department<br />
of Orthopaedics at the Medical<br />
University of Vienna in 2014.<br />
She is a specialist in Paediatric<br />
Orthopaedics and Foot and<br />
Ankle Surgery. Dr. Willegger is<br />
Fellow of the European Board<br />
of Orthopaedics and Trauma<br />
Surgery (FEBOT). Her research<br />
activity covers biomechanical<br />
and arthroscopic studies on the<br />
foot and ankle, evaluation of<br />
prognostic factors in soft tissue<br />
sarcoma, and clinical studies on<br />
lower limb rotation in children.<br />
The mean ultimate load to failure was 236.9 ± 107.8 N in the JFXS group<br />
compared with 210.8±150.7 N in the HCS group. Intergroup difference was<br />
not statistically significant (p = 0.429). The most common mode of failure<br />
in HCS constructs was proximal screw head cut out (n = 6, 60%), followed<br />
by loosening of the screw head (n = 3, 30%). In JFXS constructs metatarsal<br />
shaft fracture was the most observed mode of failure (n=4, 40%), followed<br />
by screw head cut out (n = 3, 30%). There was no statistically significant<br />
difference of BMD between the groups. BMD showed a positive correlation<br />
with the pooled ultimate load (R = 0.580, p = 0.007) for all constructs. It<br />
correlated negatively with angulation (angulation at first loading cycle:<br />
R=−0.676, p = 0.003), which was significant for every load cycle among<br />
all tested constructs (angulation at cycle 10: R=−0.552, p=0.002; cycle<br />
100–1,000: p≤0.001).<br />
Conclusion<br />
This biomechanical study shows that both screw constructs (solid fracture-specific<br />
screws versus conventional cannulated headless compression<br />
screws) provide equal ultimate loads and stiffness in a Jones<br />
fracture fixation model. In addition, low BMD seems to be related to a<br />
diminished primary stability and impaired ultimate load in intramedullary<br />
Jones fracture fixation.
TOP-Studien<br />
65<br />
Development of a New<br />
Electronic Navigation System<br />
Development of an electronic navigation system for elimination<br />
of examiner-dependent factors in the ultrasound screening for<br />
developmental dysplasia of the hip in newborns: The presented<br />
paper demonstrates an innovative problem solution to improve<br />
the quality of sonographic hip dysplasia screening, which is<br />
established in the mother-child-pass screening program. It was<br />
developed based on scientific preliminary work at the Medical<br />
University of Vienna.<br />
„Compared to established aids such as<br />
positioning aids for the baby (cradles)<br />
and mechanical transducer guiding<br />
devices, the main advantage of the<br />
presented system is the accurate<br />
detection of the pelvic position.“<br />
Alexander Kolb<br />
Sonography of the infant hip, according to Graf, is the gold standard for early<br />
diagnosis of hip dysplasia 1 . Despite this standardization, examinerdependent<br />
influences on the measurement results have been repeatedly<br />
discussed 2,3 , with tilt of the transducer position in relation to the hip joint<br />
(tilt error) being of importance 4 . In addition to structured training of the<br />
examiners, the aforementioned tilt errors were addressed in particular by<br />
aids such as a positioning aid for the baby (cradle) and a mechanical transducer<br />
guiding device („Sono Guide“ according to Graf). The importance of<br />
these tilt errors was demonstrated using an opto-electronic motion capture<br />
system to capture the transducer position 4 . However, one limitation of the<br />
opto-electronic system is due to its sensor size, making it impossible to capture<br />
the pelvic/hip position of the baby. Thus, analogous to the mechanical<br />
transducer guiding device („Sono Guide“), a defined transducer orientation is<br />
achievable, but the pelvic/hip position remains an uncertainty factor.<br />
Study:<br />
Kolb A, Chiari C, Schreiner M,<br />
Heisinger S, Willegger M, Rettl<br />
G, Windhager R. Development<br />
of an electronic navigation<br />
system for elimination of<br />
examiner-dependent factors<br />
in the ultrasound screening for<br />
developmental dysplasia of<br />
the hip in newborns. Sci Rep.<br />
<strong>2020</strong> Oct 2;10(1):16407.<br />
The aim of this work is the development of a new electronic navigation system,<br />
which is able to detect both pelvic/hip position and transducer position,<br />
and thus contributes to the minimization of examiner-dependent influences<br />
in the sense of relative transducer tilts.<br />
Materials and Methods<br />
A novel electronic navigation system was used to quantify relative tilts<br />
between the pelvis and the transducer (tilt errors) as part of the Graf sonographic<br />
hip dysplasia screening 5,6 : This system consists of two spatial<br />
position sensors, with one sensor fixed to the transducer and the second<br />
sensor epicutaneously attached centrally dorsally over the os sacrum (see<br />
Figure 1). The two sensors are each composed of an accelerometer, a gyroscope<br />
and a magnetometer. Software calculates the relative tilt between the<br />
pelvis and the transducer at three angles (in the frontal, axial, and sagittal<br />
planes) and displays it visually as a navigation aid for the examiner 6 . For<br />
each of the children examined, a sonogram was prepared without the aid of
TOP-Studien<br />
66<br />
Figure 1: Illustration of the position of the<br />
two 3D spatial position sensors: spatial<br />
position sensor epicutaneously centrally<br />
dorsally over the os sacrum for recording<br />
the pelvic position (white arrow (A and B)),<br />
transducer with 3D-printed adapter and<br />
spatial position sensor (white star (A)).<br />
Figure 2: Illustration of the relative tilt<br />
angles between the pelvis/hip joint and the<br />
transducer in the frontal plane (roll) and<br />
axial plane (pitch): (a) transducer alignment<br />
using the navigation system, (b) conventional<br />
alignment of the transducer without<br />
navigation system.<br />
the electronic navigation system (conventional), as well as a sonogram using<br />
the electronic navigation system (navigated), whereby here the transducer<br />
was aligned by the examiner according to the displayed measurement data.<br />
In both sonograms, care was taken to ensure that the sonographic criteria<br />
according to Graf were met.<br />
Results<br />
In total, data from 25 infant hips could be used in 15 consecutive infants;<br />
in five infants, measurement was unilateral due to increasing restlessness.<br />
The tilt angles between the transducer and pelvic sensor of conventional hip<br />
sonography and navigated hip sonography are shown for the frontal plane<br />
(roll angle) and axial plane (pitch angle) in Figure 2 and Table 1.<br />
This test of variance showed significant differences for tilt in the frontal<br />
plane (roll angle, p
TOP-Studien<br />
67<br />
Table 1: Relative roll and pitch angles (between<br />
infant pelvis and transducer in the frontal and<br />
axial planes) for measurements without navigation<br />
(conventional) and for measurements with<br />
navigation system (nav); boldface = significant.<br />
Table 1 min max mean std.-deviation<br />
pitch-angle (conventionel) -23,8° 14,2° 0,6° 9,26<br />
roll-angle (conventionel) -12,5° 14,3° -0,9° 7,68<br />
pitch-angle (nav) -2,8° 4,5° 0,4° 2,23<br />
roll-angle (nav) -3,0° 3,5° 0,3° 2,15<br />
the navigation system significantly reduces the variance of the roll and pitch<br />
angles, i.e. the relative tilt between the infant’s pelvis and the transducer, but<br />
also that the mean value remains unchanged by the alignment with navigation<br />
with regard to these two tilt angles. This means that a more accurate alignment<br />
of the transducer with respect to the pelvis is achieved by the navigation<br />
system, while the target alignment to the original method according to Graf<br />
remains unchanged.<br />
Compared to established aids such as positioning aids for the baby (cradles)<br />
and mechanical transducer guiding devices, the main advantage of the<br />
presented system is the accurate detection of the pelvic position. An additional<br />
strength is not only the accuracy achieved, but also the documentation<br />
of the 3D data, which increases the safety of the method for patients and<br />
examiners.<br />
A limitation of this work is the small size of the collective. Therefore, although<br />
a highly significant improvement in transducer alignment in the frontal and<br />
axial planes could be shown, no significant effect on sonographic alpha<br />
angle could be presented. However, there seems to be a tendency for the<br />
alpha-angles to be reduced under a transducer alignment corresponding to<br />
the navigation data.<br />
Conclusion<br />
This work shows that the alignment between pelvis and transducer can be<br />
significantly improved by the presented navigation system. This represents<br />
a promising approach to increase the quality of the screening program.<br />
Further studies in a large collective are necessary to analyze the effects on<br />
the sonographically measured hip parameters.<br />
Priv.-Doz. Dr. Alexander Kolb<br />
Author:<br />
Alexander Kolb, senior physician,<br />
head of the outpatient clinic<br />
for femoropatellar pathologies<br />
at the Department of Orthopaedics<br />
and Trauma Surgery,<br />
Medical University of Vienna.<br />
Endocert surgeon; 2014 GOTS<br />
fellow. Specialties: Pediatric<br />
orthopedics, endoprosthetics,<br />
sports orthopedics.<br />
References:<br />
1 <br />
Graf, R. Fundamentals of sonographic diagnosis of infant hip dysplasia. J. Pediatr. Orthop. 4,<br />
735–740 (1984).<br />
2 <br />
Ea, S. et al. Inter-observer agreement of ultrasonographic measurement of alpha and beta angles<br />
and the final type classification based on the Graf method. 671–678<br />
3 <br />
Roposch, A., Graf, R. & Wright, J. G. Determining the reliability of the Graf classification for hip<br />
dysplasia. Clin. Orthop. Relat. Res. 447, 119–24 (2006).<br />
4 <br />
Kolb, A. et al. Measurement considerations on examiner-dependent factors in the ultrasound<br />
assessment of developmental dysplasia of the hip. Int. Orthop. 41, 1245–1250 (2017).<br />
5 <br />
Kolb, A. et al. Development of an electronic navigation system for elimination of examiner-dependent<br />
factors in the ultrasound screening for developmental dysplasia of the hip in newborns. Sci. Rep. 10,<br />
1–5 (<strong>2020</strong>).<br />
6 <br />
Kolb, A. Electronic Transducer Guiding Device for the Sonographic Screening for Developmental<br />
Dysplasia of the Hip. MUW Technol. Offer. 782.18 (2019). doi:10.1007/s00264-017-3455-9
Publikationen<br />
68<br />
Originalarbeiten <strong>2020</strong><br />
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dieser Zeitschrift veröffentlichter Artikel von anderen wissenschaftlichen Artikeln<br />
pro Jahr zitiert wird. Die ersten 20 Prozent der Zeitschriften des Fachgebietes im<br />
Journal Citation Reports (geordnet nach Höhe des Impact Factors) sind Top-Journale.<br />
Die zwischen 20 und 60 Prozent liegenden Zeitschriften gelten als Standard-Journale.<br />
Folgend sind hier die Top- und Standard-Publikationen des Jahres <strong>2020</strong> angeführt.<br />
Universitätsklinik für<br />
Orthopädie und Unfallchirurgie<br />
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Agibetov A, Seirer B, Dachs TM, Koschutnik M, Dalos D, Rettl<br />
R, Duca F, Schrutka L, Agis H, Kain R, Auer-Grumbach M,<br />
Binder C, Mascherbauer J, Hengstenberg C, Samwald M,<br />
Dorffner G, Bonderman D. Machine Learning Enables Prediction<br />
of Cardiac Amyloidosis by Routine Laboratory Parameters:<br />
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3;9(5):1334. (5.688)<br />
Acem I, Verhoef C, Rueten-Budde AJ, Grünhagen DJ, van<br />
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Aston W, Bonenkamp H, Desar IME, Ferguson PC, Fiocco<br />
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Szkandera J, Tanaka K, Tunn P-U, Willegger M, Windhager<br />
R, Wunder JS, Zaikova O. Age-related differences of oncological<br />
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UK, Weber M, Windhager R, Trattnig S. Potential predictive<br />
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Benca E, Listabarth S, Flock FKJ, Pablik E, Fischer C, Walzer<br />
SM, Dorotka R, Windhager R, Ziai P. Analysis of Running-Related<br />
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Feb 6;9(2):438. (5.688)<br />
Boettner F, Sculco P, Faschingbauer M, Rueckl K, Windhager<br />
R, Kasparek MF. Clinical outcome of posterior-stabilized<br />
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Buchtele N, Herkner H, Schörgenhofer C, Merrelaar A, Laggner<br />
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B, Schwameis M. High Platelet Reactivity after Transition<br />
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69<br />
Bumberger A, Koller U, Hofbauer M, Tiefenboeck TM, Hajdu<br />
S, Windhager R, Waldstein W. Ramp lesions are frequently<br />
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<strong>2020</strong> Mar;28(3):840-854 (3.170)<br />
Chiari C, Grgurevic L, Bordukalo-Niksic T, Oppermann H, Valentinitsch<br />
A, Nemecek E, Staats K, Schreiner M, Trost C, Kolb<br />
A, Kainberger F, Pehar S, Milosevic M, Martinovic S, Peric M,<br />
Sampath TK, Vukicevic S, Recombinant Human BMP6 Applied<br />
Within Autologous Blood Coagulum Accelerates Bone Healing:<br />
Randomized Controlled Trial in High Tibial Osteotomy Patients.<br />
J Bone Miner Res. <strong>2020</strong> Oct;35(10):1893-1903 (5.854)<br />
Carlson BB, Salzmann SN, Shirahata T, Ortiz Miller C, Carrino<br />
JA, Yang J, Reisener MJ, Sama AA, Cammisa FP, Girardi<br />
FP, Hughes AP. Prevalence of osteoporosis and osteopenia<br />
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fusion patients. Neurosurg Focus. <strong>2020</strong> Aug;49(2):E5 (3.642)<br />
Cortese, A., Zhu, Y., Rebelo, A.P. Negri S., Courel S., Abreu L.,<br />
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MC, Feely S, Athanasiou-Fragkouli A, Haridy NA, Inherited<br />
Neuropathy Consortium*, Isasi R, Khan A, Laurà M, Magri<br />
S, Pipis M, Pisciotta C, Powell E, Rossor AM, Saveri P, Sow den<br />
JE, Tozza S, Vandrovcova J, Dallman J, Grignani E, Marchioni<br />
E, Scherer SS, Tang B, Lin Z, Al-Ajmi A, Schüle R, Synofzik<br />
M, Maisonobe T, Stojkovic T, Au er-Grumbach M, Abdelhamed<br />
MA, Hamed SA, Zhang R, Manganelli F, Santoro L,<br />
Taroni F, Pareyson D, Houlden H, Herrmann DN, Reilly MM,<br />
Shy ME, R. Zhai G, Zuchner S. Biallelic mutations in SORD<br />
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May;52(5):473-481, (27.605)<br />
Faschingbauer M, Kasparek M, Waldstein W, Schadler P,<br />
Reichel H, Boettner F. Cartilage survival of the knee strongly<br />
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Arthrosc. <strong>2020</strong> May;28(5):1346-1355. (3.170)<br />
Frenzel S, Horas K, Rak D, Boelch SP, Rudert M, Holzapfel<br />
BM, Acetabular Revision With Intramedullary and Extramedullary<br />
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Gravesteijn BY, Nieboer D, Ercole A, Lingsma HF, Nelson D,<br />
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Gravesteijn BY, Sewalt CA, Nieboer D, Menon DK, Maas A,<br />
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10.1016/j.bja.<strong>2020</strong>.05.067. Epub <strong>2020</strong> Jul 31 (6.880)<br />
Gstoettner C, Mayer JA, Rassam S, Hruby LA, Salminger S,<br />
Sturma A, Aman M, Harhaus L, Platzgummer H, Aszmann<br />
OC. Review. Neuralgic amyotrophy: a paradigm shift in diagnosis<br />
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Gregori M, Eichelberger L, Gahleitner C, Hajdu S, Pretterklieber<br />
M. Relationship between the Thickness of the Coracoid<br />
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Hanreich C, Martelanz L, Koller U, Windhager R, Waldstein W.<br />
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Haider T, Leister I, Mattiassich G, Kramer JLK, Linde LD, Pajalic<br />
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Predicting Total Knee Replacement from Symptomology and<br />
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Henderson ER, Keeney BJ, Husson EG, Bernthal NM, Ji T,<br />
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FJ, Letson GD, Temple HT. Nonmechanical Revision<br />
Indications Portend Repeat Limb-Salvage Failure Following<br />
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Jacob L, Cogné M, Tenovuo O, Røe C, Andelic N, Majdan M,<br />
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Kalsi-Ryan S, Rienmueller AC, Riehm L, Chan C, Jin D, Martin<br />
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Werner M, von Kalle T, Nathrath M, Burdach S, Bielack S, von<br />
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Koller U, Springer B, Rentenberger C, Szomolanyi P, Waldstein<br />
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<strong>2020</strong>, 132 (23-24), S.: 801<br />
Okano I, Salzmann SN, Ortiz Miller C, Rentenberger C,<br />
Schadler P, Sax OC, Shue J, Sama AA, Cammisa FP, Girardi FP,<br />
Hughes AP. Correlation between Urine N-Terminal Telopeptide<br />
and Fourier Transform Infrared Spectroscopy Parameters: A<br />
Preliminary Study J Osteoporos. <strong>2020</strong> Feb 11;<strong>2020</strong>:5725086.<br />
doi: 10.1155/<strong>2020</strong>/5725086. eCollection <strong>2020</strong><br />
Payr S. Perioperatives Management in der Kindertraumatologie.<br />
Jatros Orthopädie & Traumatologie Rheumatologie<br />
Payr S. Thorakolumbale Frakturen: eine Herausforderung bei<br />
älteren Patienten. Jatros Orthopädie & Traumatologie Rheumatologie<br />
Rentenberger C, Okano I, Salzmann SN, Shirahata T, Reisener<br />
MJ, Shue J, Sama AA, Cammisa FP, Girardi FP, Hughes AP.<br />
Determinants of Postoperative Spinal Height Change among<br />
Adult Spinal Deformity Patients with Long Construct Circumferential<br />
Fusion. Asian Spine J. <strong>2020</strong> Sep 3. doi: 10.31616/<br />
asj.<strong>2020</strong>.0010. Online ahead of print. PMID: 32872760<br />
Rentenberger C, Okano I, Salzmann SN, Winter F, Plais N,<br />
Burkhard MD, Shue J, Sama AA, Cammisa FP, Girardi FP,<br />
Hughes AP. World Neurosurg. Perioperative Risk Factors<br />
for Early Revisions in Stand-Alone Lateral Lumbar Interbody<br />
Fusion. <strong>2020</strong> Feb;134:e657-e663. doi: 10.1016/j.<br />
wneu.2019.10.164. Epub 2019 Nov 4. PMID: 31698117<br />
Richter K, Chiari C. Epiphyseolysis capitis femoris (ECF),<br />
Sports.Orthop. Traumatol. 36. 296-299 (<strong>2020</strong>).<br />
Rothbauer M, Schuller P, Afkhami R, Wanzenboeck HD, Ertl<br />
P, Zirath H. Microfluidic microarray for single-cell analysis.<br />
e & i Elektrotechnik und Informationstechnik volume 137,<br />
pages108–112(<strong>2020</strong>).<br />
Salzmann SN, Okano I, Shue J, Hughes AP. Disabling Pruritus<br />
in a Patient With Cervical Stenosis. J Am Acad Orthop Surg<br />
Glob Res Rev <strong>2020</strong> Mar 9;4(3):e19.00178.<br />
Schwarz-Nemec U, Friedrich KM, Prayer D, Trattnig S,<br />
Schwarz FK, Weber M, Bettelheim D, Grohs JG, Nemec SF.<br />
Lumbar Intervertebral Disc Degeneration as a Common Incidental<br />
Finding in Young Pregnant Women as Observed on<br />
Prenatal Magnetic Resonance Imaging. J Womens Health<br />
(Larchmt). <strong>2020</strong> Jan 14. doi: 10.1089/jwh.2019.7964. [Epub<br />
ahead of print]<br />
Schwarz-Nemec U, Friedrich KM, Arnoldner MA, Schwarz FK,<br />
Weber M, Trattnig S, Grohs JG, Nemec SF. When an incidental<br />
MRI finding becomes a clinical issue: Posterior lumbar subcutaneous<br />
edema in degenerative, inflammatory, and infectious<br />
conditions of the lumbar spine. Wien Klin Wochenschr.<br />
<strong>2020</strong> Jan;132(1-2):27-34. doi: 10.1007/s00508-019-01576-x<br />
Sigmund IK, Windhager R. Management der intraoperativen<br />
Diagnostik bei periprothetischen Gelenksinfektionen. JAT-<br />
ROS, Orthopädie & Traumatologie Rheumatologie 6 / <strong>2020</strong><br />
Simon S, Resch H. Treatment of hypophosphatasia. Wiener<br />
Medizinische Wochenschrift volume 170, pages 112–<br />
115(<strong>2020</strong>)<br />
Staals EL, Sambri A, Campanacci DA, Muratori F, Leithner A,<br />
Gilg MM, Gortzak Y, Van De Sande M, Dierselhuis E, Mascard<br />
E, Windhager R, Funovics P, Schinhan M, Vyrva O, Sys G,<br />
Bolshakov N, Aston W, Gikas P, Schubert T, Jeys L, Abudu A,<br />
Manfrini M, Donati DM. Expandable distal femur megaprosthesis:<br />
A European Musculoskeletal Oncology Society study<br />
on 299 cases. J Surg Oncol. <strong>2020</strong> Jun 7<br />
Starlinger J, Balls-Berry J, Amadio PC. RE: Aliuskevicius M,<br />
Ostgaard SE, Hauge EM, et al. 2019. Influence of ibuprofen<br />
on bone healing after Colles‘ fracture: A randomized controlled<br />
clinical trial. J Orthop Res. <strong>2020</strong> Jun;38(6):1204-<br />
1205. doi: 10.1002/jor.24582. Epub <strong>2020</strong> Jan 9. (2,730)<br />
Toegel S, Benca E, Negrin L, Windhager R. Neustrukturierung<br />
der <strong>Forschung</strong>slandschaft im neuen Fach Orthopädie und<br />
Traumatologie am Beispiel einer Universitätsklinik. Jatros<br />
Orthpädie & Traumatologie, Rheumatologie<br />
Willegger M, Schuh R. Arthroscopically Assisted Tape Augmentation<br />
for Anterior Talofibular Ligament Repair. Arthrosc<br />
Tech. <strong>2020</strong> May 14;9(6):e809-e816. doi: 10.1016/j.<br />
eats.<strong>2020</strong>.02.017. eCollection <strong>2020</strong> Jun.<br />
Willegger M, Schuh R, Trnka HJ. Komplikationen chirurgischer<br />
Eingriffe an den Kleinzehen. FussSprungg (<strong>2020</strong>),<br />
https://doi.org/10.1016/j.fuspru.<strong>2020</strong>.06.002<br />
Willegger M, Schuh R. Komplikationen der Tarsometatarsale<br />
I Arthrodese (modifizierte Lapidus Arthrodese). FussSprungg<br />
(<strong>2020</strong>), https://doi.org/10.1016/j.fuspru.<strong>2020</strong>.08.005<br />
Winter F, Okano I, Salzmann SN, Rentenberger C, Shue J,<br />
Sama AA, Girardi FP, Cammisa FP, Hughes AP. A Novel and<br />
Reproducible Classification of the Vertebral Artery in the<br />
Subaxial Cervical Spine Oper Neurosurg (Hagerstown). <strong>2020</strong><br />
Jun 1;18(6):676-683. doi: 10.1093/ons/opz310.<br />
Windhager R, Hobusch GM. The role of surgery in soft tissue<br />
sarcoma: Can we improve outcome and function towards<br />
sporting activities? March <strong>2020</strong>. memo - Magazine of European<br />
Medical Oncology 13(1)<br />
Wozasek GE: Mythos und Tatsachen der Knochenverlängerung.<br />
Jatros Orthopädie & Traumatologie Rheumatologie<br />
06/<strong>2020</strong><br />
Buchbeiträge<br />
Benca E. Das instabile Sprunggelenk richtig stabilisieren.<br />
In R. Windhager. <strong>Kompendium</strong> <strong>Forschung</strong> & <strong>Klinik</strong> 2019. (S.<br />
22–24). Wien: Unlimited Media<br />
Grohs, Kainberger. Rückenbeschwerden. In Klinisches und
Publikationen<br />
77<br />
ritisches Denken. Manual klinischer Symptome, Syndrome<br />
und anderer Anlassfälle inklusive e-Learning-Plattform.<br />
Franz Kainberger, Georgios Karanikas, Gerit Schernthaner,<br />
Thomas Szekeres. ISBN: 978-3-7089-2071-9; 1. Auflage<br />
<strong>2020</strong>; 185-8<br />
Trattnig S, Welsch GH, Röhrich S, Schreiner MM, Zalaudek M,<br />
Magnetic resonance imaging of the ultrastructural composition<br />
of articular cartilage in disease and repair - Articular<br />
Cartilage of the Knee: Health, Disease and Therapy. 1 January<br />
<strong>2020</strong>, Pages 343-369<br />
Rothbauer M, Ertl P. (<strong>2020</strong>) Emerging Biosensor Trends in<br />
Organ-on-a-Chip. In: Advances in Biochemical Engineering/Biotechnology.<br />
Springer, Berlin, Heidelberg. https://doi.<br />
org/10.1007/10_<strong>2020</strong>_129<br />
Diplomarbeiten/Dissertationen<br />
Chiari C, Willegger M: Karin Hebenstreit. Assessment of the<br />
lower limb torsion in rotational MRI of children – A reliability<br />
study<br />
Egkher A: Wendelken Moritz. Entwicklung einer Diagnosestraße<br />
zur Propriozeptionsmessung bei Pathologien der<br />
unteren Extremität – traumatische Epiphysenlösungen des<br />
Hüftkopfes bei Jugendlichen – Spätergebnisse nach Abschluss<br />
des Wachstums. 07.04.<strong>2020</strong><br />
Giurea A: Franz Xaver Feichtinger. Vergleich: Navigationsdaten<br />
und Röntgenanalyse<br />
Giurea A: Richard Koza. Outcome von Knierevisionsprothesen<br />
7 Jahresergebnisse<br />
Gregori M, Aldrian S: Simek Rosemarie. Clinical und radiological<br />
results after conservative and operative treatment of<br />
bony Bankart lesions 24.08.<strong>2020</strong><br />
Gregori M, Aldrian S: Hegenbart Denise. Epidemiologie und<br />
Behandlungsmöglichkeiten bei traumatischer hinterer<br />
Schulterluxation 09.07.<strong>2020</strong><br />
Grohs J: Feuerstein Laurin. Adjacent Segment Degeneration<br />
with Floating Fusions: A Prospective Study <strong>2020</strong><br />
Grohs J: Winkler Sebastian. A long-term evaluation of patient<br />
satisfaction after posterior lumbar interbody fusion: 20-years<br />
follow-up <strong>2020</strong><br />
Haider T, Hajdu S: Seiler und Aspang Jesse. Postoperative<br />
blood loss in patients with femoral neck fractures treated<br />
with hip arthroplasty – Comparison of lateral and supine positioning.<br />
A retrospective data analysis. 05.12.2019<br />
Haider T, Hajdu S: Fornather Christina. Retrospective evaluation<br />
of endoprosthetic treatment in femoral neck fracture<br />
patients with emphasis on perioperative hospitalisation and<br />
complication rates. 07.04.<strong>2020</strong><br />
Halát G: Lichtnecker Bernadette. Verletzungsassoziierte<br />
Charakteristika, Therapiealgorithmen und Komplikationspotential<br />
bei animalischen Bissverletzungen im Erwachsenenalter<br />
– eine retrospektive Datenanalyse.<br />
Halát G: Dissertation: Clinical and biomechanical characteristics<br />
of surgical repair in bony avulsions of the flexor digitorum<br />
profundus tendon and introduction of an innovative<br />
repair technique<br />
Hofbauer M, Tiefenböck T: Gruber Samuel. Operative Behandlung<br />
der symptomatischen anterioren glenohumeralen<br />
Instabilität mittels Labral-Bridge-Technique – eine Single<br />
Center Analyse. 03.06.<strong>2020</strong><br />
Lass R, Rentenberger C: Daniel Birgsteiner. Navigierte Hüftendoprothetik<br />
– Verlaufsbeobachtung einer prospektiv randomisierten<br />
Kontrollstudie<br />
Lass R, Co-Betreuer: Lukas Rabitsch. 10-Jahres Untersuchung<br />
nach zementfreier Knietotalendoprothese<br />
Maier B, Aldrian S: Hauer Ulrike. Das akute Kompartmentsyndrom<br />
im Kindes- und Jugendalter: Evaluation von Prädiktoren,<br />
Risikofaktoren und Outcome. 04.06.<strong>2020</strong><br />
Negrin L: Moftakhar Timon. Suprakondyläre Humerusfrakturen<br />
bei Kindern – eine retrospektive Datenanalyse.<br />
31.10.2019<br />
Negrin L: Zejnilovic Sara. Erhöht das Vorliegen einer Suizidabsicht<br />
das Sterberisiko bei Polytrauma-Patienten.<br />
10.06.<strong>2020</strong><br />
Negrin L: Masterabschluss Sportmedizin an der Donauuniversität<br />
Krems<br />
Sarahrudi K, Payr S: Plötzl Anna. Retrospektive Analyse<br />
radiologischer Parameter von Wirbelkörperfrakturen des<br />
thorakolumbalen Überganges an der Universitätsklinik für<br />
Orthopädie und Unfallchirurgie, Medizinische Universität<br />
Wien. 30.10.2019<br />
Sarahrudi K, Hingsammer A: Voscak Simon. Clinical Outcome<br />
of Conservative Treatment of Isolated Lateral Clavicular Fractures<br />
- A Retrospective Data Analysis. 21.11.2019<br />
Thalhammer G: Peyman Kheder. Ultraschall-basierte Evaluation<br />
des Musculus pronator quadratus nach beugeseitiger<br />
Verplattung bei distaler Radiusfraktur – Vergleich zweier<br />
operativer Zugänge. 24.10.2019<br />
Thalhammer G: Maria-Theresia Rattasits. Injuries of flexor<br />
tendons in zone 2: a retrospective analysis to compare two<br />
suture materials. 03.12.2019<br />
Thalhammer G: Michaela Pröll. Behandlung von Kahnbeinpseudarthrosen<br />
mittels avaskulärem Knochentransplantat<br />
und Schraube – Retrospektive Evaluation der klinischen und<br />
radiologischen Ergebnisse. 09.01.<strong>2020</strong><br />
Toegel S: Dr. Mahmoud Elshamly. PhD thesis: Intervertebral<br />
disc degeneration: Role of galectins in its pathogenesis and<br />
postoperative complications in its surgical treatment. PhD<br />
defense: 27.11.<strong>2020</strong>.<br />
Waldstein W: Pottmann Christoph.Erstellung von Lernkurven<br />
in der präoperativen Planung der azetabulären Komponente<br />
zur endoprothetischen Versorgung der Coxarthrose.<br />
06.04.<strong>2020</strong><br />
Widhalm H: Huber Felix. Evaluation des klinischen Outcomes<br />
von PatientInnen, die sich eine proximale Humerusfraktur<br />
zugezogen haben – Operation vs. konservative Therapie.<br />
05.12.2019<br />
Zak L, Aldrian S: Vandermuntert Maxime. Vergleich pedobarometrischer<br />
und koordinativer Ergebnisse nach konservativ<br />
oder operativ behandelten Weber B Außenknöchelfrakturen<br />
– eine Pilotstudie zur Untersuchung der kurzfristigen Insta-
Publikationen<br />
78<br />
bilität und Sportfähigkeit – eine exploratorische prospektive<br />
Studie. 06.07.<strong>2020</strong><br />
Preise<br />
Benca E: Stefan-Schuy-Preis der Österreichischen Gesellschaft<br />
für Biomedizinische <strong>Forschung</strong>. QCT-based finite element<br />
prediction of pathologic fractures in proximal femora<br />
with metastatic lesions. November <strong>2020</strong>, online<br />
Böhler C: Arthur Vick Preis (5.000 Euro)<br />
Haider T: AO Trauma Fellowship<br />
Haider T: Open Access Förderung der Österreichischen<br />
Gesellschaft für Unfallchirurgie<br />
Halát G: Grand Rounds Award „Docere cum Laude” Medizinische<br />
Universtiät Wien – Grand Rounds<br />
Humenberger M: Open-Access-Förderpreis der Österreichischen<br />
Gesellschaft für Unfallchirurgie, 1. Platz<br />
Moftakhar T: Emanuel-Trojan-Posterpreis der Österreichischen<br />
Gesellschaft für Unfallchirurgie<br />
Negrin L: Open Access Förderung der Österreichischen<br />
Gesellschaft für Unfallchirurgie<br />
Nia A: Österreichische Gesellschaft für Knochen und Mineralstoffwechsel<br />
(ÖGKM) – Projektpreis 2019/20 für das Projekt:<br />
Bone metabolism, bone microarchitecture, bone marrow<br />
fat composition and vascular calcifications in men with and<br />
without type- 2 diabetes mellitus and fragility fractures<br />
Nürnberger S: Researcher of the Month Dezember <strong>2020</strong> der<br />
MedUni Wien<br />
Rienmüller A.: „Orthopaedic fellow research award best poster<br />
prize <strong>2020</strong>” 28.5.<strong>2020</strong>, University of Toronto, Division of<br />
Orthopaedic Surgery.<br />
Rothbauer M: FFG Innovationsscheck, Stabilität von Oberflächenbeschichtungen<br />
für Zellkultur. Gesamtsumme: 12.500 €<br />
Staats K: 3. Posterpreis Endoprothetikkongress, Berlin<br />
Deutschland, 13.-15.02.<strong>2020</strong>, „Osseointegrative Effekte von<br />
intermittierender Parathormongabe bei initialer Instabilität<br />
von zementfreien Implantaten“<br />
Toegel S (Senior and corresponding author): „Wissenschaftspreis<br />
<strong>2020</strong>” (Science Award) of the Association for<br />
Orthopaedic Research (AFOR) für Daniela Weinmann für die<br />
Publikation „Galectin-8 induces functional disease markers<br />
in human osteoarthritis and cooperates with galectins-1<br />
and -3”.<br />
Toegel S (Senior and corresponding author): „Wissenschaftspreis<br />
<strong>2020</strong>” (Science Award) of the Austrian Spine<br />
Society to Mahmoud Elshamly for publication DOI:10.1002/<br />
jor.24351. Galectins-1 and -3 in Human Intervertebral Disc<br />
Degeneration: Non‐Uniform Distribution Profiles and Activation<br />
of Disease Markers Involving NF-κB by Galectin-1.<br />
Waldstein W: - ‚Reviewer of the Year‘: Archives of Orthopaedic<br />
and Trauma Surgery – Featured Author im Juli <strong>2020</strong> im Journal<br />
‚Bone & Joint Research‘ für die Publikation: Serum cobalt<br />
concentrations remain at low levels at a minimum of 20 years<br />
following metal-on-metal total hip arthroplasty.<br />
Drittmittelfinanzierte Projekte<br />
Projektleitung: Halát G<br />
Vorstellung einer innovativen, Ankerbasierten Rekonstruktionstechnik<br />
in der chirurgischen Therapie der A2-Ringband<br />
Ruptur<br />
Medizinisch-Wissenschaftlicher Fonds des Bürgermeisters<br />
der Bundeshauptstadt Wien - Projektnummer 20029<br />
Zuteilungsdatum: 04.06.<strong>2020</strong><br />
Laufzeit: 6 Monate bis Mai 2021<br />
Gesamtsumme: 1.000 Euro<br />
Projektleitung: Humenberger M<br />
In-vivo Testung einer magnesiumbasierten, intramedullären<br />
Spannosteosynthese im Kaninchenmodell (MgBioISOS)<br />
Förderung der Österreichischen Gesellschaft für Unfallchirurgie<br />
Start: 22.10.2018<br />
Laufzeit: 30 Monate<br />
Projektlaufzeit: 22.10.2018–01.04.2021<br />
Gesamtfördersumme: 17.039,84 Euro<br />
Projektleitung: Maier B<br />
Beurteilung des Heilungsprozesses bei konservativ behandelten<br />
distalen Radiusfrakturen sowie Identifizierung<br />
osteoporotischer Frakturen bei postmenopausalen Frauen<br />
mittels HrPQCT (hochauflösende periphere quantitative<br />
Computertomographie)<br />
Medizinisch-Wissenschaftlicher Fonds des Bürgermeisters<br />
der Bundeshauptstadt Wien – Projektnummer 20043<br />
Zuteilungsdatum: 04.06.<strong>2020</strong><br />
Laufzeit: 18 Monate bis Juni 2022<br />
Gesamtsumme: 2.000 Euro<br />
Projektleitung: Negrin L<br />
Welche Schlussfolgerungen lässt der zeitliche Verlauf von<br />
Biomarkerspiegeln, die im Blut von Polytrauma-Patienten<br />
erhoben werden, zu? – Eine Pilotstudie<br />
Förderung der Österreichischen Gesellschaft für Unfallchirurgie<br />
Start: Jänner 2019<br />
Laufzeit: 48 Monate<br />
Projektlaufzeit: 01.2019–12.2022<br />
Gesamtfördersumme: 10.000 Euro<br />
Projektleitung: Nürnberger S<br />
Cartilage for Cartilage regeneration: Laser engraved decellularized<br />
cartilage as biomaterial for defect treatment<br />
FFG Bridge 1 Projekt<br />
Bewilligung: Juni 2019<br />
Laufzeit: 36 Monate<br />
Projektlaufzeit: 01.10.2019–30.09.2022<br />
Gesamtfördersumme: 317.936 Euro (UCO 40.748 Euro)<br />
Projektleitung: Nürnberger S<br />
Laserbasierte Methode zur Wiederbesiedelung von dezellularisierter<br />
Knorpelmatrix (LaserScaffold) für die Knorpelregeneration<br />
Lorenz Böhler Fonds<br />
Bewilligung: Mai 2019<br />
Projektlaufzeit: 01.09.2019–28.02.2021<br />
Lauzzeit: 18 Monate<br />
Gesamtfördersumme: 33.464 Euro<br />
Projektleitung: Nürnberger S<br />
Biological skin plug system – Characterization of the attachment<br />
cement in ticks
Publikationen<br />
79<br />
Zuteilungsdatum: 28.04.2016<br />
Laufzeit: bis 27.04.2021<br />
Gesamtsumme: 351.254,40 Euro (davon MedUniWien:<br />
196.702 Euro)<br />
Projektleitung: Staats K<br />
Titel: Functionalization of Nanopatterned Titanium (Ti) for<br />
Biomedical Application (FTiBA)<br />
Geldgeber: CEST<br />
Zuteilungsnummer: FA737A1701<br />
Zuteilungsdatum: 15.09.<strong>2020</strong><br />
Laufzeit: 15,5 Monate<br />
Voraussichtliche Fertigstellung: 31.12.2021<br />
Gesamtsumme: 33.696 Euro<br />
Projektleitung: Toegel S.<br />
Titel: Identifizierung von Galektinrezeptoren in arthrotischen<br />
Knorpelzellen<br />
Geldgeber: Johnson&Johnson<br />
Zuteilungsdatum: 01.08.2019<br />
Laufzeit: 18 Monate<br />
Vorraussichtliche Fertigstellung des Projekts: Ende 2021<br />
Gesamtsumme: 75.000 Euro<br />
Projektleitung: Widhalm HK<br />
The Clinical Relevance of micro RNAs in Mild Traumatic<br />
Brain Injury– A Pilot Study<br />
Thema: Micro RNA Diagnostik bei Schädelhirntrauma<br />
Geldgeber: Bürgermeisterfonds der Stadt Wien<br />
Zuteilungsdatum: 01.12.2015<br />
Laufzeit in Monaten: 60 Monate<br />
Voraussichtliche Fertigstellung des Projekts: Ende <strong>2020</strong><br />
Gesamtsummer: 13.000 Euro<br />
Projektleitung: Windhager R.<br />
Titel: Allofit IT with HXPE in Total Hip Arthroplasty<br />
Geldgeber: Zimmer Biomet Austria GmbH<br />
Zuteilungsdatum: 30.05.2012<br />
Laufzeit: 30.05.2012–31.01.2024<br />
Vorraussichtliche Fertigstellung des Projekts: 31.01.2024<br />
Gesamtsumme: 156.800 Euro<br />
Projektleitung: Windhager R.<br />
Titel: Attune Kurz-, mittel- und langfristige Haltbarkeit von<br />
Attune primären Knie-Totalendoprothesen<br />
Geldgeber: DePuy Synthes<br />
Zuteilungsdatum: 15.02.2013<br />
Laufzeit: 15.02.2013–15.12.2029<br />
Vorraussichtliche Fertigstellung des Projekts: 15.12.2029<br />
Gesamtsumme: 52.767 Euro<br />
Projektleitung: Windhager R.<br />
Titel: OSTEOproSPINE<br />
Geldgeber: EU H<strong>2020</strong><br />
Zuteilungsdatum: 01.01.2018<br />
Laufzeit: 01.01.2018–31.12.2022<br />
Vorraussichtliche Fertigstellung des Projekts: 31.12.2022<br />
Gesamtsumme: 740.000 Euro<br />
Projektleitung: Windhager R.<br />
Titel: Educational Grant<br />
Geldgeber: Johnson&Johnson<br />
Zuteilungsdatum: 02.05.2018<br />
Laufzeit: 02.05.2018–31.12.<strong>2020</strong><br />
Vorraussichtliche Fertigstellung des Projekts: 31.12.<strong>2020</strong><br />
Gesamtsumme: 16.500 Euro<br />
Projektleitung: Windhager R.<br />
Titel: Ausbildungsstipendium/Funktionalität des Galektin-<br />
Netzwerks in der arthrotischen Knorpeldegeneration<br />
Geldgeber: Johnson&Johnson<br />
Zuteilungsdatum: 01.07.2018<br />
Laufzeit: 01.07.2018–31.12.<strong>2020</strong><br />
Vorraussichtliche Fertigstellung des Projekts: 31.12.<strong>2020</strong><br />
Gesamtsumme: 30.000 Euro<br />
Projektleitung: Windhager R.<br />
Titel: Lopain-Studie<br />
Geldgeber: MESTEX<br />
Zuteilungsdatum: 27.06.2018<br />
Laufzeit: 27.06.2018–31.12.<strong>2020</strong><br />
Vorraussichtliche Fertigstellung des Projekts: 31.12.<strong>2020</strong><br />
Gesamtsumme: 62.000 Euro<br />
Projektleitung: Windhager R.<br />
Titel: ACTIS<br />
Geldgeber: Johnson&Johnson/DePuyProducts,Inc.<br />
Zuteilungsdatum: 01.12.2010<br />
Laufzeit: 01.12.2010–31.12.2022<br />
Vorraussichtliche Fertigstellung des Projekts: 31.12.2022<br />
Gesamtsumme: 100.000 Euro<br />
Projektleitung: Windhager R.<br />
Titel: Reference Center Agreement<br />
Geldgeber: Medacta<br />
Zuteilungsdatum: 01.06.<strong>2020</strong><br />
Laufzeit: 01.06.<strong>2020</strong>–31.05.2022<br />
Vorraussichtliche Fertigstellung des Projekts: 31.05.2022<br />
Gesamtsumme: 10.000 Euro<br />
Vorsitz bei Tagungen/Wissenschaftliche Leitung<br />
Aldrian S: Vorsitz und Organisation. Novel Cartilage, Bone &<br />
Joint Approaches, Austrian Cluster for Tissue Regeneration<br />
Annual Meeting February 17th – 19th <strong>2020</strong> Österreich<br />
Aldrian S: Vorsitz. Wirbelsäule und Neurologie, 56. Jahrestagung<br />
der Österreichischen Gesellschaft für Unfallchirurgie<br />
(ÖGU) und 1. Jahrestagung der Österreichischen<br />
Gesellschaft für Orthopädie und Traumatologie (ÖGOuT),<br />
01.–03.10.<strong>2020</strong>, Salzburg, Österreich<br />
Chiari C: Kursorganisation. Ausbildungskurs der Medizinischen<br />
Universität Wien – Sonografie der Säuglingshüfte<br />
nach Graf – 15.–16.Oktober <strong>2020</strong><br />
Frenzel S: Vorsitz. Workshop des Jungen Forums der ÖGU<br />
– Wirbelsäule – Wesentliche Grundlagen für AssistentInnen,<br />
56. Jahrestagung der Österreichischen Gesellschaft<br />
für Unfallchirurgie (ÖGU) und 1. Jahrestagung der Österreichischen<br />
Gesellschaft für Orthopädie und Traumatologie<br />
(ÖGOuT), 01.-03.10.<strong>2020</strong>, Salzburg, Österreich<br />
Frenzel S: Vorsitz. Sitzung des Jungen Forums der ÖGU,<br />
56. Jahrestagung der Österreichischen Gesellschaft für<br />
Unfallchirurgie (ÖGU) und 1. Jahrestagung der Österreichischen<br />
Gesellschaft für Orthopädie und Traumatologie<br />
(ÖGOuT), 01.-03.10.<strong>2020</strong>, Salzburg, Österreich<br />
Grohs J: 21. Symposium der Österr. Ges. für Wirbelsäulenchirurgie.<br />
Die Säulen der Wirbelsäule, Wien 25.01.<strong>2020</strong><br />
Grohs J: Webinar. Die Wirbelsäulenchirurgie in der Corona-<br />
Krise – Degenerative Wirbelsäulenerkrankungen. 07.05.<strong>2020</strong>
Publikationen<br />
80<br />
Humenberger M: Vorsitz. Klausursitzung der Zukunftskommission<br />
der ÖGU, 21.–22.02.<strong>2020</strong> Österreich<br />
Humenberger M: Vorsitz. Grundlagen Schaftfrakturen, 1. ÖGU<br />
& 1. ÖGOuT WEBINAR Versorgung von Schaftfrakturen –Teil 1<br />
29. April <strong>2020</strong> Österreich<br />
Humenberger M: Vorsitz. Versorgung von Schaftfrakturen<br />
–Teil 2, 2. ÖGU & 2. ÖGOuT WEBINAR Versorgung von Schaftfrakturen<br />
–Teil 2 19. Mai <strong>2020</strong> Österreich<br />
Humenberger M: Vorsitz. Becken & Hüfte –Teil 1, 3. ÖGU & 3.<br />
ÖGOuT WEBINAR Becken & Hüfte –Teil 1 19. Juni <strong>2020</strong> Österreich<br />
Humenberger M: Vorsitz. Ellbogen und Unterarm, 69. ÖGU<br />
Fortbildung/5. ÖGU & 5. ÖGOuT Webinar Ellbogen und Unterarm<br />
20.–21. November <strong>2020</strong> Österreich<br />
Humenberger M: Wissenschaftliche Leitung. Grundlagen<br />
Schaftfrakturen, 1. ÖGU & 1. ÖGOuT WEBINAR Versorgung<br />
von Schaftfrakturen – Teil 1 29. April <strong>2020</strong> Österreich<br />
Humenberger M: Wissenschaftliche Leitung. Versorgung<br />
von Schaftfrakturen –Teil 2, 2. ÖGU & 2. ÖGOuT WEBI-<br />
NAR Versorgung von Schaftfrakturen –Teil 2 19. Mai <strong>2020</strong><br />
Österreich<br />
Kdolsky R: Vorsitz. ESTES Webinar „Proximal humerus fractures“,<br />
28 SEP <strong>2020</strong><br />
Kdolsky R: Vorsitz. ESTES Webinar „Geriatric polytrauma –<br />
what is different?”, 23 NOV <strong>2020</strong><br />
Nürnberger S: Vorsitz. Novel Cartilage, Bone & Joint<br />
Approaches, Austrian Cluster for Tissue Regeneration Annual<br />
Meeting February 17th – 19th <strong>2020</strong> Österreich<br />
Nürnberger S: Vorsitz. Cartilage & Joints, Austrian Cluster for<br />
Tissue Regeneration Annual Meeting February 17th – 19th<br />
<strong>2020</strong> Österreich<br />
Pajenda G: Vorsitz. Postervorträge, 56. Jahrestagung der<br />
Österreichischen Gesellschaft für Unfallchirurgie (ÖGU)<br />
und 1. Jahrestagung der Österreichischen Gesellschaft für<br />
Orthopädie und Traumatologie (ÖGOuT), 01.–03.10.<strong>2020</strong>,<br />
Salzburg, Österreich<br />
Sigmund I: Vorsitz: SYMPOSIUM OF ORTHOPEDIC SEPTIC<br />
REVISION 2 (Graz) 25.01.<strong>2020</strong><br />
Sigmund I: Vorsitz: Interactive PJI Webinar, 17.06.<strong>2020</strong> (Austria)<br />
Windhager R: Wissenschaftliche Leitung. Medacta Surgical<br />
Days, 13.–16. Oktober <strong>2020</strong>, Graz<br />
Präsidentschaften und Funktionen bei Journalen<br />
Antoni A: Reviewer Journal of Clinical Medicine<br />
Antoni A: Beratendes Mitglied der ADNANI (Interdisziplinäre<br />
Arbeitsgemeinschaft Neuromedizin)<br />
Antoni A: Kassenprüferin der ÖGU (Österreichische Gesellschaft<br />
für Unfallchirurgie)<br />
Böhler C: Reviewer Bone and Joint Journal<br />
Böhler C: Reviewer Journal of Bone Oncology<br />
Böhler C: Reviewer BMJ Open<br />
Böhler C: Reviewer Rheumatology Oxford Journal<br />
Chiari C: Vizepräsidentin der Österreichischen Gesellschaft<br />
für Orthopädie<br />
Chiari C: Der Orthopäde, Rubrikherausgeberin CME Zertifizierte<br />
Fortbildung<br />
Frenzel S: Reviewer Plos ONE<br />
Gregori M: Reviewer Archives of Orthopaedic and Trauma<br />
Surgery<br />
Giurea A: Guest Editor: Acta Chirurgica Austriaca<br />
Giurea A: Wissenschaftlicher Beirat bei IATROS<br />
Grohs J: Corresponding Member der North American Spine<br />
Society (NASS)<br />
Grohs J: Beirat der Österreichischen Gesellschaft für Wirbelsäulenchirurgie<br />
Grohs J: Preiskommittee Otto Kraupp Preis 24.10.<strong>2020</strong><br />
Grohs J: Reviewer Wiener Klinische Wochenschrift<br />
Grohs J: Reviewer Journal of clinical Medicine<br />
Grohs J: Reviewer British Journal of Neurosurgery<br />
Haider T: Reviewer Injury – International Journal of the Care<br />
of the Injured<br />
Haider T: Reviewer European Journal of Trauma and Emergency<br />
Surgery<br />
Haider T: Reviewer British Medical Journal (BMJ) Open<br />
Holzer S: Präsidiumsmitglied der Österreichische Gesellschaft<br />
für Musik und Medizin (ÖGfMM) Leitung der AG Musikermedizin<br />
<strong>2020</strong>–2022<br />
Humenberger M: Reviewer Injury – International Journal of<br />
the Care of the Injured<br />
Humenberger M: Reviewer Thrombosis and Haemostasis –<br />
International Journal for Vascular Biology and Medicine<br />
Humenberger M: Reviewer PLOS ONE<br />
Humenberger M: Reviewer Journal of Clinical Medicine<br />
Kdolsky R: Section chair ESTES: skeletal trauma and sports<br />
medicine<br />
Lang N: Reviewer Journal of Clinical Medicine<br />
Lang N: Reviewer Scientific Reports<br />
Lang N: Reviewer Diagnostics<br />
Lass R: Editorial Board Austin Journal of Orthopedics &<br />
Rheumatology<br />
Lass R: Editorial Board World Journal of Orthopedics<br />
Lass R: Reviewer Journal of Orthopedic Research<br />
Lass R: Reviewer Bone & Joint Research<br />
Lass R: Reviewer BMC Muskuloskeletal Disorders<br />
Lass R: Reviewer Diagnostic Microbiology<br />
Lass R: Reviewer European Journal of Clinical Microbiology<br />
& Infectious Diseases<br />
Lass R: Reviewer Expert Reviews<br />
Lass R: Reviewer Journal of Functional Biomaterials<br />
Negrin L: Editorial Board Member Journal of Trauma & Treatment<br />
Negrin L: Editorial Board Member Journal of Clinical Trials<br />
Negrin L: Reviewer Bioscience Reports<br />
Negrin L: Reviewer BMC Pulmonary Medicine<br />
Negrin L: Reviewer Journal of Orthopaedic Surgery and Research<br />
Nürnberger S: Reviewer Acta Biomaterialia<br />
Nürnberger S: Reviewer Ticks and Tick born deseases<br />
Pajenda G: Reviewer Archives of Orthopaedic and Trauma<br />
Surgery
Publikationen<br />
81<br />
Payr S: Reviewer Journal of Orthopedic Surgery and Research<br />
Rothbauer M: Editor Organs-on-a-chip<br />
Salzmann S: Reviewer Spine (Phila Pa 1976)<br />
Salzmann S: Reviewer World Neurosurgery<br />
Salzmann S: Reviewer Current Sports Medicine Reports<br />
Salzmann S: Reviewer Osteoporosis International<br />
Staats K: Journal of Arthroplasty<br />
Staats K: Journal of Clinical Medicine<br />
Staats K: Assistent*innenvertreter Österreichische Gesellschaft<br />
für Orthopädie<br />
Starlinger J: Reviewer International Orthopaedics<br />
Starlinger J: Reviewer Scientific Reports<br />
Stelzeneder B: Reviewer European Radiology<br />
Thalhammer G: Reviewer Arthroscopy<br />
Thalhammer G: Reviewer Zeitschrift für Orthopädie und Unfallchirurgie<br />
Tiefenböck T: Reviewer Journal of Orthopedic Surgery and<br />
Research<br />
Tiefenböck T: Reviewer Journal of Clinical Medicine<br />
Tiefenböck T: Reviewer Plos One<br />
Toegel S: Reviewer Biomedicine & Pharmacotherapy<br />
Toegel S: Reviewer Molecular Medicine Reports<br />
Toegel S: Reviewer Cells Tissues Organs, Osteoarthritis and<br />
Cartilage<br />
Toegel S: Reviewer Scientific Reports<br />
Toegel S: Referent für die Österreichische Akademie der<br />
Wissenschaften (OeAW)<br />
Toegel S: Referent Förderprogramm DOC<br />
Toegel S: Gutachter für die Deutsche <strong>Forschung</strong>sgemeinschaft<br />
(DFG)<br />
Toegel S: Gutachter einer Dissertation für die Medizinische<br />
Universität Wien<br />
Toegel S: Gutachter einer Dissertation für die Universität für<br />
Bodenkultur Wien<br />
Waldstein W: Reviewer Archives of Orthopaedic and Trauma<br />
Surgery<br />
Waldstein W: Reviewer Bone and Joint Journal<br />
Widhalm HK: Reviewer Journal of Clinical Medicine<br />
Widhalm HK: Reviewer American Journal of Sportsmedicine<br />
(AJSM)<br />
Widhalm HK: Reviewer Knee Surgery Sports Traumatology<br />
Arthroscopy (KSSTA)<br />
Widhalm HK: Reviewer Neuosurgical Review<br />
Widhalm HK: Reviewer Obesity Surgery<br />
Willegger M: Reviewer International Orthopaedics, BMC<br />
Musculoskeletal Disorders, Journal of Oncology<br />
Willegger M: Generalsekretärin – Österreichische Gesellschaft<br />
für Fußchirurgie<br />
Willegger M: Genderbeauftrage – Österreichische Gesellschaft<br />
für Orthopädie<br />
Windhager R: Mitherausgeber von Journal of Ortopaedic<br />
and Traumatology (SIOT)<br />
Windhager R: Mitherausgeber der Z ORTHOP<br />
Windhager R: Editorial Board Member, Journal of Orthopaedic<br />
Translation<br />
Windhager R: Mitglied des wissenschaftlichen Beirates der<br />
Zeitschrift „Arzt + Patient“<br />
Windhager R: Reviewer Acta Orthopedica<br />
Windhager R: Reviewer British Journal of Surgery<br />
Windhager R: Reviewer Clinical Orthopaedics and Related<br />
Research<br />
Windhager R: Reviewer Der Orthopäde<br />
Windhager R: Reviewer EFORT Open Reviews<br />
Windhager R: Reviewer Journal of Orthopaedic Translation<br />
Windhager R: Reviewer Journal of Clinical Medicine<br />
Windhager R: Reviewer Vorstandsmitglied ÖGO<br />
Windhager R: Mitglied des Wissenschaftlichen Komitees<br />
der ÖGO<br />
Windhager R: Korrespondierendes Mitglied der Deutschen<br />
Gesellschaft für Orthopädie und orthopädische Chirurgie<br />
(DGOOC) ab Oktober 2016<br />
Windhager R: Mitglied der AE-Akademie (Arbeitsgemeinschaft<br />
Endoprothetik) ab 06.12.2013<br />
Windhager R: Mitglied des Vereins zur Förderung von Wissenschaft<br />
und <strong>Forschung</strong> in den neuen Universitätskliniken<br />
am Allgemeines Krankenhaus der Stadt Wien<br />
Windhager R: Mitglied des Advisory Board, Comprehensive<br />
Cancer Center, Graz ab Juli 2014<br />
Windhager R: Mitglied der MedUni Ethikkommission ab<br />
01.03.2010<br />
Windhager R: Ordentliches Mitglied der Europäischen Akademie<br />
der Wissenschaften und Künste März, 2013<br />
Windhager R: Ehrenmitglied: Italienische Gesellschaft für<br />
Orthopädie und Traumatologie (SIOT)<br />
Windhager R: Ehrendmitglied: Böhmischen Gesellschaft für<br />
Orthopädie und Traumatologie<br />
Wozasek GE: Reviewer Injury – International Journal of the<br />
Care of the Injured<br />
Wozasek GE: Fachgruppenobmann der Fachgruppe Unfallchirurgie<br />
Wien<br />
Besuchte Kurse und Kongresse<br />
Aldrian S: ÖGU-Arbeitskreis Knie, 10.1.<strong>2020</strong>, AUVA, Wien<br />
Aldrian S: Austrian Cluster for Tissue Regeneration Annual<br />
Meeting February 17.2.–19.2.<strong>2020</strong>, Wien<br />
Aldrian S: Austrian Knee Symposium 6.3.<strong>2020</strong> Graz<br />
Aldrian S: 56. Jahrestagung der Österreichischen Gesellschaft<br />
für Unfallchirurgie (ÖGU) und 1. Jahrestagung der<br />
Österreichischen Gesellschaft für Orthopädie und Traumatologie<br />
(ÖGOuT), 01.–03.10.<strong>2020</strong>, Salzburg, Österreich<br />
Antoni A: AO Spine Principles Seminar – Intraoperative Imaging,<br />
14. Februar <strong>2020</strong>, Lille, Frankreich<br />
Antoni A: 56. Jahrestagung der Österreichischen Gesellschaft<br />
für Unfallchirurgie (ÖGU) und 1. Jahrestagung der<br />
Österreichischen Gesellschaft für Orthopädie und Traumatologie<br />
(ÖGOuT), 01.-03.10.<strong>2020</strong>, Salzburg, Österreich<br />
(online)<br />
Antoni A: Deutscher Wirbelsäulenkongress/15. Jahrestagung<br />
der Deutschen Wirbelsäulengesellschaft 09.12.<strong>2020</strong>–<br />
11.12.<strong>2020</strong> (online)<br />
Böhler C: 13. Endoprothetik Kongress Berlin. 13.02.<strong>2020</strong>–<br />
15.02.<strong>2020</strong><br />
Chiari C: Bernese Hip Symposium <strong>2020</strong> – 27.–29. Februar<br />
<strong>2020</strong>, Bern, Schweiz<br />
Chiari C: AGA-Jahreskongress-Online, 16.–19.9.<strong>2020</strong><br />
Chiari C: Virtual EFORT Congress 28.-30. October <strong>2020</strong> (online)
Publikationen<br />
82<br />
Döring K: 56. ÖGU Jahrestagung der ÖGU & 1. Jahrestagung<br />
der ÖGOuT „Wirbelsäule“ – ONLINE. 1.–3.10.<strong>2020</strong><br />
Frenzel S: 56. Jahrestagung der Österreichischen Gesellschaft<br />
für Unfallchirurgie (ÖGU) und 1. Jahrestagung der Österreichischen<br />
Gesellschaft für Orthopädie und Traumatologie<br />
(ÖGOuT), 01.–03.10.<strong>2020</strong>, Salzburg, Österreich (online)<br />
Frenzel S: AO Trauma Online Masters Course–Fragility<br />
Fractures December 03.–04.12.<strong>2020</strong>, Davos, Switzerland<br />
Grohs J: 21. Symposium der Österr. Ges. für Wirbelsäulenchirurgie,<br />
Wien 25.1.<strong>2020</strong><br />
Halát G: Grund- und Spezielle Ausbildung zum Strahlenschutzbeauftragten.<br />
Nuclear Engineering Seibersdorf, Österreichisches<br />
<strong>Forschung</strong>szentrum Juni <strong>2020</strong><br />
Halát G: ITS Kurs „Becken und proximaler Humerus“ Anatomisches<br />
Institut, Graz<br />
03.09.<strong>2020</strong>–04.09.<strong>2020</strong><br />
Humenberger M: Frenzel S: 56. Jahrestagung der Österreichischen<br />
Gesellschaft für Unfallchirurgie (ÖGU) und 1. Jahrestagung<br />
der Österreichischen Gesellschaft für Orthopädie<br />
und Traumatologie (ÖGOuT), 01.–03.10.<strong>2020</strong>, Salzburg,<br />
Österreich (online)<br />
Lang N: AE Masterkurs Knie, München<br />
Lang N: AE Masterkurs Hüfte, München<br />
Negrin L: Swiss Pelvic & Acetabular Course, 17. Jänner <strong>2020</strong>,<br />
Zürich (Schweiz)<br />
Negrin L: Swiss Pelvic & Acetabular Course, 18. Jänner <strong>2020</strong>,<br />
Solothurn (Schweiz)<br />
Negrin L: Internationaler Fortbildungskongress für Sportmedizin,<br />
8.–14. März <strong>2020</strong>, St. Christoph<br />
Negrin L: Notarztrefresher-Kurs (Schockraum + Pädiatrie),<br />
8–9. Juni <strong>2020</strong>, Natters<br />
Negrin L: Zertifikatskurs: Anti-Doping und Dopingprävention<br />
(Basismodul und Spezialmodule), 17–19. September<br />
<strong>2020</strong>, Hall in Tirol<br />
Negrin L: 56. Jahrestagung der Österreichischen Gesellschaft<br />
für Unfallchirurgie (ÖGU) und 1. Jahrestagung der Österreichischen<br />
Gesellschaft für Orthopädie und Traumatologie<br />
(ÖGOuT), 01.-03.10.<strong>2020</strong>, Salzburg, Österreich (online)<br />
Negrin L: ITS Masterclass: Professionell, konstruktiv und<br />
kreativ – Shaping the Future, 22. Oktober <strong>2020</strong>, online<br />
Negrin L: ÖÄK-Zertifikat Antidoping und Dopingprävention<br />
Nürnberger S: Erste Schritte mit Webex (Distant Learning)<br />
Nürnberger S: Der virtuelle Hörsaal mit Webex (Distant Learning)<br />
Nürnberger S: PE-Seminar „Woran erkennt man schlechte<br />
<strong>Forschung</strong>“<br />
Payr S: AE-Masterkurs Hüfte, München, 09.–10.10.<strong>2020</strong><br />
Payr S: 56. Jahrestagung der Österreichischen Gesellschaft<br />
für Unfallchirurgie (ÖGU) und 1. Jahrestagung der Österreichischen<br />
Gesellschaft für Orthopädie und Traumatologie<br />
(ÖGOuT), 01.–03.10.<strong>2020</strong>, Salzburg, Österreich<br />
Rentenberger C: 56. Jahrestagung der Österreichischen<br />
Gesellschaft für Unfallchirurgie (ÖGU) und 1. Jahrestagung<br />
der Österreichischen Gesellschaft für Orthopädie und Traumatologie<br />
(ÖGOuT), 01.–03.10.<strong>2020</strong>, Salzburg, Österreich<br />
Rothbauer M: SELECTBIO Innovations in Microfluidics conference<br />
17–18th August <strong>2020</strong> in Boston MA<br />
Rothbauer M: Annual Conference EUROoCS <strong>2020</strong>, Uppsala,<br />
Sweden, 8–9 July <strong>2020</strong><br />
Schreiner MM: AE-Basis-Kompaktkurs „Hüft- und Knieendoprothetik“<br />
03.–04.09.<strong>2020</strong> Berlin<br />
Sigmund I: OBIC (Webinar) 08.12.<strong>2020</strong> (best paper)<br />
Sigmund I: EBJIS (Webinar) 05.10.<strong>2020</strong> How to build a BIU<br />
Sigmund I: EBJIS (Webinar) 15.12.<strong>2020</strong> Diabetic Foot Infection<br />
Springer B: Wiener Handkurs – Basiskurs, 29.06.–03.07.<strong>2020</strong><br />
Staats K: Endoprothetikkongress <strong>2020</strong>, Berlin, Deutschland,<br />
13.–15.02.<strong>2020</strong><br />
Staats K: Current Concepts in Joint Replacement, (online)<br />
08.–12.12.<strong>2020</strong><br />
Stelzeneder B: 10. Jan. <strong>2020</strong>: Öffentliche Sitzung des Arbeitskreises<br />
Knie der ÖGU<br />
Stelzeneder B: 28. und 29. Feb. <strong>2020</strong>: Leistungsphysiologisch-Internistisch-Pädiatrischer<br />
Grundkurs II, Praxisseminar<br />
(ÖÄK Diplom Sportmedizin), Wien<br />
Stelzeneder B: 29. Feb. und 01. März <strong>2020</strong>: Orthopädisch-Traumatologisch-Pädiatrischer<br />
Grundkurs I (ÖÄK Diplom<br />
Sportmedizin), Wien<br />
Stelzeneder B: 29. April <strong>2020</strong>: 1. ÖGU & 1. ÖGOuT Webinar<br />
„Versorgung von Schaftfrakturen – Teil 1“<br />
Stelzeneder B: 19. Mai <strong>2020</strong>: 2. ÖGU & 2. ÖGOuT Webinar<br />
„Versorgung von Schaftfrakturen – Teil 2“<br />
Stelzeneder B: 19. Juni <strong>2020</strong>: 3. ÖGU & 3. ÖGOuT Webinar<br />
„Becken & Hüfte – Teil 1“<br />
Stelzeneder B: 02. Juli <strong>2020</strong>: 4. ÖGU & 4. ÖGOuT Webinar<br />
„Becken & Hüfte – Teil 2“<br />
Stelzeneder B: 01.–03. Okt. <strong>2020</strong>: 56. ÖGU & 1. ÖGOuT Jahrestagung<br />
<strong>2020</strong>: Wirbelsäule (Online)<br />
Stelzeneder B: 14. Nov. <strong>2020</strong>: Neue Leitlinie Sportkardiologie<br />
der European Society Cardiology (ESC): Aktuelles für Ihre<br />
tägliche Routine. D-A-CH Sportkardiologie (ÖÄK Sportmedizin<br />
Diplom) (online)<br />
Stelzeneder B: 20.+21.Nov. <strong>2020</strong>: 5. ÖGU & 4. ÖGOuT Webinar<br />
„Ellbogen und Unterarm“<br />
Thalhammer G: 1. ÖGU & 1. ÖGOuT Webinar „Versorgung von<br />
Schaftfrakturen – Teil 1“, am 29. April <strong>2020</strong><br />
Thalhammer G: 2. ÖGU & 2. ÖGOuT Webinar „Versorgung von<br />
Schaftfrakturen – Teil 2“, am 19. Mai <strong>2020</strong><br />
Thalhammer G: ISAKOS Webinar, Difficult Elbow Problems:<br />
Heterotopic Ossification and Calcification, held on June 5,<br />
<strong>2020</strong><br />
Thalhammer G: Touching Hands Webinar: Practical Details<br />
that Make Tendon and Nerve Transfer Successful, Saturday,<br />
November 7, <strong>2020</strong><br />
Thalhammer G: 56. Jahrestagung der Österreichischen Gesellschaft<br />
für Unfallchirurgie (ÖGU) und 1. Jahrestagung<br />
der Österreichischen Gesellschaft für Orthopädie und Traumatologie<br />
(ÖGOuT), 01.–03.10.<strong>2020</strong>, Salzburg, Österreich<br />
Thalhammer G: 4. ÖGU & 4. ÖGOuT Webinar „Becken & Hüfte<br />
– Teil 2“ teilgenommen, am 25. Juni <strong>2020</strong><br />
Thalhammer G: 69. ÖGU Fortbildung / 5. ÖGU & 5. ÖGOuT Webinar<br />
„Ellbogen und Unterarm“, am 20.–21. November <strong>2020</strong><br />
Thalhammer G: AO Webinar – Extra-Articular Distal Radius<br />
Malunion and its Correction<br />
Thalhammer G: AO Webinar – Bail-Out in Complex Distal Radial<br />
Fractures<br />
Thalhammer G: AO Webinar – Distal Radial Fractures - The<br />
Good, the Bad, and the Ugly<br />
Thalhammer G: IWAS WEBINAR, Arthroscopy in Scaphoid
Publikationen<br />
83<br />
fracture, Wrist Arthroscopy in scaphoid non-union, 3D Printing<br />
Assisted Percutaneous Fixation of Scaphoid Fracture<br />
and undisplaced non-union, 11. Dez. <strong>2020</strong><br />
Tiefenböck T: ÖGU-Arbeitskreis Knie, 10.1.<strong>2020</strong>, AUVA, Wien<br />
Tiefenböck T: 56. Jahrestagung der Österreichischen Gesellschaft<br />
für Unfallchirurgie (ÖGU) und 1. Jahrestagung der Österreichischen<br />
Gesellschaft für Orthopädie und Traumatologie<br />
(ÖGOuT), 01.–03.10.<strong>2020</strong>, Salzburg, Österreich<br />
Tiefenböck T: GOTS Kongress online, 16.–18. Juni <strong>2020</strong><br />
Tiefenböck T: 37. AGA-Kongress <strong>2020</strong> AGAnywhere – Virtual.<br />
Global.Local 17.–19. September <strong>2020</strong><br />
Weihs V: ASSH <strong>2020</strong> – American Society for Surgery of the<br />
Hand Annual Meeting – San Antonio - ONLINE, October 1,<br />
<strong>2020</strong> - October 3, <strong>2020</strong><br />
Weihs V: 56. Jahrestagung der Österreichischen Gesellschaft<br />
für Unfallchirurgie (ÖGU) und 1. Jahrestagung der Österreichischen<br />
Gesellschaft für Orthopädie und Traumatologie<br />
(ÖGOuT), 01.–03.10.<strong>2020</strong>, Salzburg, Österreich (online)<br />
Widhalm HK: Konsensusmeeting – „Das Knie- Arbeitskreis<br />
Knie“ der ÖGU: AUVA Wien, 10.01.<strong>2020</strong><br />
Widhalm HK: Zukunftskommissions-Meeting der ÖGU,<br />
AUVA Meidling, 21.–22.02.<strong>2020</strong><br />
Widhalm HK: 1.ÖGU & 1.ÖGOuT Webinar: „Versorgung von<br />
Schaftfrakturen Teil 1“, 29.04.<strong>2020</strong><br />
Widhalm HK: 2.ÖGU & 2.ÖGOuT Webinar: „Versorgung von<br />
Schaftfrakturen Teil 2“, 19.05.<strong>2020</strong><br />
Widhalm HK: 3.ÖGU & 3.ÖGOuT Webinar: „Becken und Hüfte“,<br />
Teil 1“, 19.06.<strong>2020</strong><br />
Widhalm HK: 4.ÖGU & 4.ÖGOuT Webinar: „Becken und Hüfte“,<br />
Teil 2“, 02.07.<strong>2020</strong><br />
Widhalm HK: Virtuelles Jahrestreffen <strong>2020</strong> – DGU – Traumaregister,<br />
11.09.<strong>2020</strong><br />
Widhalm HK: AGA-Jahreskongress-Online, 16.–19.09.<strong>2020</strong><br />
Widhalm HK: 56. Jahrestagung der Österr.Gesellschaft für<br />
Unfallchirurgie,„Wirbelsäule “, Wien-Online, 01.–03.10.<strong>2020</strong><br />
Willegger M: Bernese Hip Symposium Pre-Course <strong>2020</strong> –<br />
26. Februar <strong>2020</strong>, Bern, Schweiz<br />
Willegger M: Workshop Kinderfuß der D.A.F. am 13.11.<strong>2020</strong><br />
in Stuttgart (online)<br />
Willegger M: Bernese Hip Symposium <strong>2020</strong> – 27.–29.Februar<br />
<strong>2020</strong>, Bern, Schweiz<br />
Willegger M: Virtual EFORT Congress 28.–30.October <strong>2020</strong><br />
(online)<br />
Willegger M: AOFAS Annual Meeting <strong>2020</strong> 09.–12. September<br />
– San Antonio, Texas, USA (online)<br />
Willegger M: Kursorganisation: Ausbildungskurs der Medizinischen<br />
Universität Wien – Sonografie der Säuglingshüfte<br />
nach Graf – 15.–16.Oktober <strong>2020</strong><br />
Zak L: ÖGU-Arbeitskreis Knie, 10.1.<strong>2020</strong>, AUVA, Wien<br />
Zak L: Austrian Cluster for Tissue Regeneration Annual<br />
Meeting February 17.2.–19.02.<strong>2020</strong>, Wien<br />
Zak L: 2.ÖGU Web. „Versorgung Schaftfrakturen“, 19.05.<strong>2020</strong><br />
Zak L: Bonesupport Webinar – CeramentG, 28.05.<strong>2020</strong><br />
Zak L: 4. ÖGU Webinar „Becken & Hüfte“, 02.06.<strong>2020</strong><br />
Zak L: Nuvasive Webinar – Bone Transport Nail, 27.08.<strong>2020</strong><br />
Zak L: MSc Sportmedizin - Modul 1, 21.–26.09.<strong>2020</strong><br />
Zak L: EFAS Webinar - Adult Flatfoot, 23.09.<strong>2020</strong><br />
Zak L: GOTS Schweiz Webinar, 24.09.–25.09.<strong>2020</strong><br />
Zak L: 56. Jahrestagung der Österreichischen Gesellschaft<br />
für Unfallchirurgie (ÖGU) und 1. Jahrestagung der Österreichischen<br />
Gesellschaft für Orthopädie und Traumatologie<br />
(ÖGOuT), 01.-03.10.<strong>2020</strong>, Salzburg, Österreich<br />
Zak L: MSc Sportmedizin – Modul 3, 12.–17.10.<strong>2020</strong><br />
Zak L: NewClip Webinar – Umstellungsosteotomien,<br />
23.10.<strong>2020</strong><br />
Zak L: 69. ÖGU Webinar „Ellbogen und Unterarm“, 21.11.<strong>2020</strong><br />
Zak L: STORZ Webinar „Pre-Xmas Special”, 08.12.<strong>2020</strong><br />
Zak L: MSc Sportmedizin – Modul 3, 18.–23.01.2021<br />
Vorträge<br />
Aldrian S: Eingeladener Vortrag: Möglichkeit bei der Behandlung<br />
von Knorpeldefekten, Austrian Knee Symposium – Orthopädie<br />
und Traumatologie rund um das Kniegelenk Österreich<br />
Benca E: Thermal effects during bone preparation for- and<br />
during insertion of osseointegrated transfemoral implants.<br />
General Assembly of the Austrian Chapter of the European<br />
Society of Biomechanics. November <strong>2020</strong>, online<br />
Chiari C: 29.10.<strong>2020</strong> Eingeladener Vortrag – Women in Orthoedics:<br />
The supported surgeon – How to maximize your potential<br />
Chiari C: 30.10.<strong>2020</strong> Live Interview: Subject: Receive an<br />
EFORT Award and learn from the best! and specifically ‚How<br />
to maximize your chances and how to write your abstract‘. In<br />
the studio with Prof Soren Overgaard.<br />
Döring K, Puchner S, Pastl K, Scarf-Osteotomie und Hallux<br />
valgus nach Austin, ASK THE EXPERT // Webinar Firma Surgebright<br />
– 05. Oktober <strong>2020</strong><br />
Fischer A, Toegel S: The glycobiology of OA: An update. Oral<br />
presentation at the 9th Scientific Meeting of the Ludwig<br />
Boltzmann Institute for Arthritis and Rehabilitation, virtual<br />
meeting. 21.–22. September <strong>2020</strong>.<br />
Frenzel S: Visionen für das Fach Orthopädie und Traumatologie<br />
aus Sicht der AssistentInnenvertreter der ÖGO und ÖGU,<br />
56. Jahrestagung der Österr. Ges. für Unfallchirurgie (ÖGU)<br />
und 1. Jahrestagung der Österr. Ges. für Orthopädie und Traumatologie<br />
(ÖGOuT), 01.–03.10.<strong>2020</strong>, Salzburg, Österreich<br />
Frenzel S: Begrüßung, Eröffnung der Sitzung und Überblick<br />
über das vergangene Jahr, 56. Jahrestagung der Österr. Ges.<br />
für Unfallchirurgie (ÖGU) und 1. Jahrestagung der Österr. Ges.<br />
für Orthopädie und Traumatologie (ÖGOuT), 01.–03.10.<strong>2020</strong>,<br />
Salzburg, Österreich<br />
Gregori M: Speichenkopffrakturen, 69. ÖGU Fortbildung/<br />
5. ÖGU & 5. ÖGOuT Webinar Ellbogen und Unterarm, 20.–21.<br />
November <strong>2020</strong>, Österreich<br />
Grohs JG: Wer braucht eine aufrechte Säule? 21. Symposium<br />
der Österr. Ges. für Wirbelsäulenchirurgie, Wien 25.01.<strong>2020</strong><br />
Grohs JG: Webinar: Die Wirbelsäulenchirurgie in der Corona-Krise<br />
– Degenerative Wirbelsäulenerkrankungen.<br />
07.05.<strong>2020</strong><br />
Grohs JG: Belastungsmuster in verschiedenen Sportarten.<br />
ULG Public Health, online 12.05.<strong>2020</strong><br />
Grohs JG: Überlastungsschäden. ULG Public Health, online<br />
12.5.2019<br />
Grohs JG: 21. Symposium der Österr. Ges. für Wirbelsäulenchirurgie,<br />
Die Säulen der Wirbelsäule, Wien 25.01.<strong>2020</strong><br />
Grohs JG: Wirbelsäulenbeschwerden Block21<br />
Grohs JG: Prüfer Returnweek 16.07.<strong>2020</strong><br />
Grohs JG: Planungsteam OSCE <strong>2020</strong><br />
Grohs JG: Planungsteam Block21 <strong>2020</strong><br />
Grohs JG: Planungsteam Block 25 <strong>2020</strong>
Publikationen<br />
84<br />
Grohs JG: Planungsteam TUT3<br />
Grohs JG: Planungsteam TUT2<br />
Grohs JG: Koordinator KPJ <strong>2020</strong><br />
Grohs JG: Gutachter Habilitation Jöstl<br />
Grohs JG: Prüfer PHD Halat<br />
Hajdu S: Eingeladener Vortrag: Welcome, Austrian Cluster<br />
for Tissue Regeneration Annual Meeting February 17th –<br />
19th <strong>2020</strong> Österreich<br />
Holzer S: Thorakale und thorakolumbale Wirbelkörperfrakturen:<br />
die endoskopisch assistierte ventrale und dorsoventrale<br />
Frakturversorgung, 56. Jahrestagung der Österr. Ges. für<br />
Unfallchirurgie (ÖGU) und 1. Jahrestagung der Österr. Ges.<br />
für Orthopädie und Traumatologie (ÖGOuT), 01.–03.10.<strong>2020</strong>,<br />
Salzburg, Österreich<br />
Humenberger M: Tibiakopffrakturen, 1. Online Fortbildung<br />
MUW, 31. März. <strong>2020</strong> Österreich<br />
Humenberger M: Grundlagen der Versorgung von Schaftfrakturen,<br />
1. ÖGU & 1. ÖGOuT WEBINAR Versorgung von<br />
Schaftfrakturen –Teil 1 29. April <strong>2020</strong> Österreich<br />
Humenberger M: Ellenbogenluxationsfrakturen, GOTS Sportarzt<br />
Zertifikatskurs, 31.07.<strong>2020</strong>, Österreich<br />
Humenberger M: Bericht aus der Zukunftskommission, 56.<br />
Jahrestagung der Österr. Ges. für Unfallchirurgie (ÖGU) und<br />
1. Jahrestagung der Österr. Ges. für Orthopädie und Traumatologie<br />
(ÖGOuT), 01.–03.10.<strong>2020</strong>, Salzburg, Österreich<br />
Kdolsky R: Eingeladender Vortrag: Komplikationen der Versorgung<br />
von Schaftfrakturen, 2. ÖGU & 2. ÖGOuT WEBINAR Versorgung<br />
von Schaftfrakturen – Teil 2 19. Mai <strong>2020</strong> Österreich<br />
Laggner R: Die Versorgung von Verletzungen am zervikothorakalen<br />
Übergang an einem Level I Traumazentrum – eine<br />
retrospektive Analyse, 56. Jahrestagung der Österr. Ges. für<br />
Unfallchirurgie (ÖGU) und 1. Jahrestagung der Österr. Ges.<br />
für Orthopädie und Traumatologie (ÖGOuT), 01.–03.10.<strong>2020</strong>,<br />
Salzburg, Österreich<br />
Lass R: Senior Mentoring-Programm der MedUniWien im<br />
Studienjahr 2019/<strong>2020</strong><br />
Nürnberger S: CartiScaff, Austrian Cluster for Tissue Regeneration<br />
Annual Meeting February 17th–19th <strong>2020</strong> – Highlights<br />
of Musculoskeletal Research and Imaging Österreich<br />
Pajenda G: Verletzungen der unteren Halswirbelsäule – Diagnostik<br />
und Therapiealgorithmus, 56. Jahrestagung der<br />
Österr. Ges. für Unfallchirurgie (ÖGU) und 1. Jahrestagung<br />
der Österr. Ges. für Orthopädie und Traumatologie (ÖGOuT),<br />
01.–03.10.<strong>2020</strong>, Salzburg, Österreich<br />
Pajenda G: Fallpräsentation: Mein schlimmster Fall, 56.<br />
Jahrestagung der Österr. Ges. für Unfallchirurgie (ÖGU) und<br />
1. Jahrestagung der Österr. Ges. für Orthopädie und Traumatologie<br />
(ÖGOuT), 01.–03.10.<strong>2020</strong>, Salzburg, Österreich<br />
Pajenda G: Eingeladener Vortrag: Trauma und Versorgung<br />
der unteren Halswirbelsäule, Webinar Johnson & Johnson<br />
Institute, 03.07.<strong>2020</strong><br />
Rienmüller A: Functional objective assessment using the<br />
TUG-test is a useful tool to evaluate outcome in lumbar spinal<br />
stenosis. 20th Annual Scientific Conference of the Canadian<br />
Spine Society, Whistler BC, Canada 26.02.–29.02.<strong>2020</strong><br />
Rienmüller A: Gait variability is a valid tool to characterize<br />
severity of degenerative cervical myelopathy: a prospective<br />
clinical study. 20th Annual Scientific Conference of the Canadian<br />
Spine Society, Whistler BC, Canada 26.02.–29.02.<strong>2020</strong><br />
Rothbauer M: Eingeladender Vortrag. SELECTBIO Innovations<br />
in Microfluidics conference 17-18th August <strong>2020</strong> in Boston<br />
MA on ‚Joint-on-a-Chip as Alternative to Animal Models in<br />
Arthritis Research‘<br />
Rothbauer M: Plus Lucis training week for chemistry and<br />
physics teachers (VFPC), Vienna, Austria (<strong>2020</strong>) on „Research<br />
without animal experiments – interdisciplinary research at<br />
the interface between chemistry, physics and biology“<br />
Schwarz G: Quality and Readability of Online Resources<br />
on Chronic Ankle Instability, 37. AGA-Kongress <strong>2020</strong> AG-<br />
Anywhere – Virtual.Global.Local, 17.–19. September <strong>2020</strong><br />
Schweiz, 17.09.<strong>2020</strong><br />
Staats K: Sitzung des Jungen Forums der ÖGU, 56. Jahrestagung<br />
der Österr. Ges. für Unfallchirurgie, 01.–02.10.<strong>2020</strong><br />
Staats K: Vorlesung (Wahlfach): „Grundlagen der Hüft- und<br />
Knieendoprothetik<br />
Starlinger J: Eingeladener Vortrag: Polytraumaversorgung<br />
in Österreich – aktuelle Konzepte und Perspektiven, BÖC<br />
Webinar Österreich<br />
Toegel S: The glycobiology of OA: Status quo and ongoing<br />
research. Oral presentation at the 8th Scientific Meeting of<br />
the Ludwig Boltzmann Institute for Arthritis and Rehabilitation,<br />
Vienna, Austria, 17. June <strong>2020</strong>.<br />
Toegel S: The glyobiology of OA: Recent progress and future<br />
perspectives. Oral presentation at the Scientific Advisory<br />
Board Meeting, Ludwig Boltzmann Institute for Arthritis and<br />
Rehabilitation, Vienna, Austria, 23. November <strong>2020</strong>.<br />
Toegel S: Basic Lecture: Osteoarthritis biology. #850.701, Vo.<br />
Study: N790 Doctoral Programme of Applied Medical Science.<br />
Thematic programme: Regeneration of Bones and Joints.<br />
Toegel S: SSM 3-Projektstudie (Wahlpflichtteil). #808.008,<br />
SK. Study: N202 Human medicine.<br />
Toegel S: Practical Seminar, #850.320, Se. Study: N790 Doctoral<br />
Programme of Applied Medical Science. Thematic programme:<br />
Regeneration of Bones and Joints.<br />
Toegel S: SSM2 - Arthrose: Von der klinischen Wissenschaft<br />
bis zur Grundlagenforschung, # 806.087, Se. Study: N202<br />
Human medicine.<br />
Toegel S: Basic Lecture: Gene expression anaylsis. #850.022,<br />
Vo. Study: N790 Doctoral Programme of Applied Medical Science.<br />
Thematic programme: Regeneration of Bones and Joints.<br />
Weihs V: Eingeladener Vortrag: Stress-induced cardiomyopathy:<br />
clinical and echocardiographic features, treatment and<br />
prognosis, 62nd Annual World Congress – ICA <strong>2020</strong> International<br />
College of Angiology Back to Back Online Meeting – 52.<br />
Jahrestagung ÖGG <strong>2020</strong> Österreichische Gesellschaft für<br />
Gefäßchirurgie Österreich<br />
Widhalm H: Erste Erfahrungen aus Österreich: Einsatz des<br />
Allograft- Transplantates bei der Rekonstruktion des vorderen<br />
Kreuzbandes, 37. AGA-Kongress <strong>2020</strong> AGAnywhere –<br />
Virtual.Global.Local, 17.–19. September <strong>2020</strong>, Schweiz<br />
Willegger M: Excellent Reliability But Significant Difference<br />
Exists Among MRI Measurement Methods For Femoral<br />
Torsion In Paediatric Patients. Virtual EFFORT Congress<br />
28.–30. October <strong>2020</strong> – Paediatric Orthopaedics / Hip<br />
Windhager R: WP1 Phase II clinical trial „Clinical update<br />
and protocol amendments“. Osteoprospine, 2nd Progress<br />
Meeting, 30.–31. Januar <strong>2020</strong>, Zagreb<br />
Windhager R: Lecture: „Resection and Reconstruction of bone
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über 100-jähriger Tradition<br />
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Mieder & Bandagen<br />
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Orthesen & Apparate<br />
Kinderorthopädische Versorgungen<br />
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Publikationen<br />
86<br />
tumors -lessons learnt from the last 3 decades“, 21.02.<strong>2020</strong>,<br />
Catholic University of Rome, Institute of Orthopedics, Rom<br />
Windhager R: Moderation: Medacta Surgical Days, 13.–16.<br />
Oktober <strong>2020</strong>, Graz<br />
Windhager R: Online Vortrag, „Current status of the trial (incl.<br />
the 2nd IDSMB report) and management under COVID-related<br />
safety measures”, 26.–27. November <strong>2020</strong> OSTEOproSPI-<br />
NE, Virtual Progress Meeting.<br />
Poster<br />
Hayer S: Distinct galectin profile in inflammatory-mediated<br />
cartilage damage. Poster presentation at the OARSI <strong>2020</strong>, Vienna,<br />
Austria<br />
Karner M, Stihsen C, Grohs J. Die Progressionsgeschwindigkeit<br />
der idiopathischen Adoleszentenskoliose und die<br />
Möglichkeit der Adaptierung des Untersuchungsintervalls.<br />
Jatros. Orthopädie & Traumatologie Rheumatologie 5 /<strong>2020</strong><br />
Moftakhar T: Inzidenz und Verletzungsmuster von Elektro-Scooter-assoziierten<br />
Verletzungen nach Einführung<br />
eines städtischen Leihprogramms in Wien – eine retrospektive<br />
multizentrische Studie, 56. Jahrestagung der Österr.<br />
Ges. für Unfallchirurgie (ÖGU) und 1. Jahrestagung der<br />
Österr. Ges. für Orthopädie und Traumatologie (ÖGOuT), 01.–<br />
03.10.<strong>2020</strong>, Salzburg, Österreich<br />
Nia A: Varos-Schaftsystem – eine Pilotstudie für den klinischen<br />
Einsatz in der Frühphase der Rehabilitation, OTWorld,<br />
27.10.<strong>2020</strong>, Deutschland<br />
Payr S: Epidemiologischer Überblick über Frakturen der Wirbelsäule<br />
bei Kindern und Jugendlichen – Daten eines Level<br />
1 Traumazentrums, 56. Jahrestagung der Österr. Ges. für<br />
Unfallchirurgie (ÖGU) und 1. Jahrestagung der Österr. Ges.<br />
für Orthopädie und Traumatologie (ÖGOuT), 01.–03.10.<strong>2020</strong>,<br />
Salzburg, Österreich<br />
Payr S: Thorakolumbale Wirbelkörperfrakturen: Eine Herausforderung<br />
beim älteren Patienten, 56. Jahrestagung der<br />
Österr. Ges. für Unfallchirurgie (ÖGU) und 1. Jahrestagung<br />
der Österr. Ges. für Orthopädie und Traumatologie (ÖGOuT),<br />
01.-03.10.<strong>2020</strong>, Salzburg, Österreich<br />
Payr S: Wirbelsäulenverletzungen beim kindlichen und jugendlichen<br />
Polytrauma, 56. Jahrestagung der Österr. Ges. für<br />
Unfallchirurgie (ÖGU) und 1. Jahrestagung der Österr. Ges.<br />
für Orthopädie und Traumatologie (ÖGOuT), 01.–03.10.<strong>2020</strong>,<br />
Salzburg, Österreich<br />
Rienmüller A: Function as objective assessment using the<br />
TUG-Test is a useful tool to evaluate outcome in lumbar spinal<br />
stenosis surgery. 28.05.<strong>2020</strong><br />
Rothbauer M: Organs-on-a-chip as alternative to animal models<br />
in orthopedic musculoskeletal disease research, Annual<br />
Conference EUROoCS <strong>2020</strong>, Uppsala, Sweden, 8–9 July <strong>2020</strong><br />
Staats K: Osseointegrative Effekte von intermittierender<br />
Parathormongabe bei initialer Instabilität von zementfreien<br />
Implantaten, Endoprothetikkongress <strong>2020</strong>, Berlin, Deutschland,<br />
13.–15.02.<strong>2020</strong><br />
Starlinger J: Post-intervention changes in the relative motion<br />
between the surrounding subsynovial connective tissue (SSCT)<br />
and tendon in the carpal tunnel, Orthopedic Research Society<br />
Phoenix, Arizona, 08.-11.02.<strong>2020</strong>, Vereinigte Staaten (USA)<br />
Steinecker-Frohnwieser B: Activation of the mechanosensitive<br />
ion channel Piezo1/2 by Yoda1 modulates cellular functions<br />
of human OA chondrocytes. Poster presentation at the<br />
OARSI <strong>2020</strong>, Vienna, Austria<br />
Toegel S: Distinct galectin profile in inflammation-mediated<br />
cartilage damage. Poster presentation at the European Workshop<br />
for Rheumatology Research <strong>2020</strong>, Leuven, Belgium,<br />
13.–15.2.<strong>2020</strong><br />
Toegel S: Galectin-4 triggers disease markers in osteoarthritic<br />
chondrocytes via NF-kB. Poster presentation at the OARSI<br />
<strong>2020</strong>, Vienna, Austria<br />
Toegel S: Glycophenotyping of osteoarthritic fibroblast-like<br />
synoviocytes. Poster presentation at the OARSI <strong>2020</strong>, Vienna,<br />
Austria<br />
Schinhan M: Biological regeneration in a compartmentalized<br />
early stage of osteoarthritis: 12-month results of a randomized<br />
trial in sheep. Poster presentation at the OARSI <strong>2020</strong>,<br />
Vienna, Austria<br />
Fischer A: The novel H2S-releasing compound DP* reduces<br />
inflammation in osteoarthritic chondrocytes and fibroblast-like<br />
synoviocytes. Poster presentation at the OARSI<br />
<strong>2020</strong>, Vienna, Austria<br />
Weihs V: Psychokardiologische Aspekte in der akuten Phase<br />
des Takotsubo-Syndroms (TTS): Eine Untersuchung von<br />
TTS-Patienten hinsichtlich somatischer und depressiver<br />
Störungen, Resilienz und Krankheitswahrnehmung, DGPPN<br />
Kongress <strong>2020</strong>, 26.11.–28.11.<strong>2020</strong>, ONLINE, Deutschland<br />
Willegger M: Arthroscopic accessibility of the metatarsal<br />
head comparing distraction and plantarflexion in a 2 portal<br />
technique for the first metatarsophalangeal (MTP 1) joint<br />
AOFAS Annual Meeting <strong>2020</strong> 9.–12. September – San Antonio,<br />
Texas, USA (online)<br />
Willegger M: Tibial Coverage Of The Talar Dome In Different<br />
Ankle Positions<br />
Virtual EFFORT Congress 28.–30.October <strong>2020</strong> – Selected for<br />
Best Poster Session<br />
Willegger M: Intraoperative Glove Perforation During Implantation<br />
Of Cephalomedullary Nails For Pertrochanteric Fracture<br />
Fixation, Virtual EFFORT Congress 28.–30. October <strong>2020</strong><br />
Gastärzte/Beobachter<br />
Name Land Dauer<br />
Jamal Al-Omari Jordanien 1.09.2019-<br />
Fellow 31.03.<strong>2020</strong><br />
01.04.<strong>2020</strong>-<br />
31.03.2021<br />
Dr. Chang-Bae Kong Süd-Korea 24.02.<strong>2020</strong>-<br />
Fellow 23.02.2021
·